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Individual

DEVISREE NEKKANTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
7010 W HIGHWAY 71 STE 225, AUSTIN, TX 78735-8341
(732) 428-9958
Mailing address
16301 DONOHER DR, AUSTIN, TX 78717-4203
(732) 428-9958

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
35850
TX
1223G0001X
General Practice Dentistry
35850
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093294233
TX
01
45859384
DRIVERS LISCENCE
TX
Enumeration date
08/08/2018
Last updated
12/05/2022
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