Individual
DR. HARISH TUMMALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(304) 890-0118
Mailing address
14102 NW 30TH AVE, GAINESVILLE, FL 32606-5392
(304) 890-0118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN24898
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN24898
FL
Other
Enumeration date
06/04/2020
Last updated
11/12/2022
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