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Individual

NAGAMANI AMBATIPUDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D

Contact information

Practice address
483 MIDDLE TURNPIKE W, SUITE 309, MANCHESTER, CT 06040
(860) 645-0111
(860) 432-4613
Mailing address
483 MIDDLE TURNPIKE W, SUITE 309, MANCHESTER, CT 06040
(860) 645-0111
(860) 432-4613

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
010499
CT
1223G0001X
General Practice Dentistry
Primary
10499
CT

Other

Enumeration date
10/25/2012
Last updated
02/07/2013
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