Individual
SARITHA KETEPALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3001 BERLIN TPKE, NEWINGTON, CT 06111-4601
(415) 347-6515
Mailing address
3001 BERLIN TPKE, NEWINGTON, CT 06111-4601
(415) 347-6515
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
057448
NY
122300000X
Dentist
11300
CT
1223G0001X
General Practice Dentistry
Primary
11300
CT
Other
Enumeration date
12/03/2014
Last updated
04/02/2015
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