Individual
SRITA CHUNDRU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1838 S 15TH ST, MILWAUKEE, WI 53204-3225
(201) 889-7383
Mailing address
1400 N LAKE SHORE DR APT 10J, CHICAGO, IL 60610-1601
(201) 889-7383
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002292-15
WI
Other
Enumeration date
06/01/2020
Last updated
06/08/2020
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