Individual
DR. PADMA DAGGULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2539 JUDSON RD, LONGVIEW, TX 75605-4643
(903) 553-1586
(903) 234-8169
Mailing address
2539 JUDSON RD, LONGVIEW, TX 75605-4643
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
27427
TX
1223G0001X
General Practice Dentistry
59728
CA
1223P0221X
Pediatric Dentistry
Primary
27427
TX
Other
Enumeration date
09/05/2011
Last updated
09/26/2011
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