Individual
PUNYA SRIKANTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4125 HARBOR TOWN LN, MANITOWOC, WI 54220-5855
(920) 686-3800
Mailing address
2388 S ONEIDA ST, ASHWAUBENON, WI 54304-5244
(920) 785-5130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002417-15
WI
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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