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Individual

DR. SRIRAM V MYNENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
935 MAIN ST, SUITE # B2, MANCHESTER, CT 06040-6059
(860) 643-0011
Mailing address
935 MAIN ST STE B2, MANCHESTER, CT 06040-6050
(860) 643-0011
(860) 646-8548

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010590
CT

Other

Enumeration date
09/25/2006
Last updated
04/02/2024
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