Individual
DR. SUMAN GORANTLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7015 E CENTRAL AVE, WICHITA, KS 67206-1943
(316) 684-5184
Mailing address
7015 E CENTRAL AVE, WICHITA, KS 67206-1943
(316) 684-5184
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30022591
OH
Other
Enumeration date
08/09/2007
Last updated
04/23/2021
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