Individual
DR. HIMABINDU GOGENENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3575 PORTAGE AVE STE A, SOUTH BEND, IN 46628-6092
(574) 349-2073
Mailing address
804 BLAKE ST APT A, INDIANAPOLIS, IN 46202-2978
(216) 556-2844
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013496A
IN
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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