Individual
DR. AVANTHIKA BALASUBRAMANIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1470 PANTOPS MOUNTAIN PL STE 1, CHARLOTTESVILLE, VA 22911-4662
(434) 817-1817
Mailing address
1470 PANTOPS MOUNTAIN PL STE 1, CHARLOTTESVILLE, VA 22911-4662
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418540
VA
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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