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Individual

DR. SIDDARDHA CHANDRUPATLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS MMSC

Contact information

Practice address
15132 OLD GALVESTON RD, WEBSTER, TX 77598-1821
(281) 990-7462
Mailing address
15132 OLD GALVESTON RD, WEBSTER, TX 77598-1821
(281) 990-7462

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
33470
TX
1223D0001X
Public Health Dentistry
Primary
33470
TX
1223G0001X
General Practice Dentistry
33470
TX
1223G0001X
General Practice Dentistry
DL12935
MA

Other

Enumeration date
11/22/2016
Last updated
07/26/2024
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