Individual
DR. VIKRAM GANUPUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4017 N PRINCE ST, CLOVIS, NM 88101-9705
(847) 915-3040
Mailing address
2610 WEDDINGTON RDG NE, MARIETTA, GA 30068-2279
(678) 923-1486
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3568
NM
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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