Individual
DR. ANAITA NALLADARU MULLASSERIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.D.S., M.S.
Contact information
Practice address
504 SHAWNEE MALL DR, SHAWNEE, OK 74804-1317
(405) 878-8899
(405) 878-8896
Mailing address
504 SHAWNEE MALL DR, SHAWNEE, OK 74804-1317
(405) 878-8899
(405) 878-8896
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
172
OK
Other
Enumeration date
01/10/2009
Last updated
07/04/2012
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