Individual
DR. SRINIVASA RAO MIDTHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1025 EL PASEO RD, LAS CRUCES, NM 88001
(888) 988-4066
Mailing address
44 JUDSON ST, APT-4B, EDISON, NJ 08837-2436
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3595
NM
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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