Individual
DR. ANITA OGHOGHO IMADOMWANYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1515 S BUCKNER BLVD, STE #223, DALLAS, TX 75217-1760
(214) 391-6868
Mailing address
533 S ST ANDREWS PL, APT #210, LOS ANGELES, CA 90020-5300
(214) 476-2157
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25180
TX
Other
Enumeration date
05/16/2010
Last updated
05/16/2010
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