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Individual

DR. SIRISHA MUNIMADUGU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BDS

Contact information

Practice address
3302 GASTON AVE, DALLAS, TX 75246-2013
(214) 828-8100
Mailing address
4603 158TH AVE SE, BELLEVUE, WA 98006-3251
(408) 431-5168

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
32775
TX
1223P0300X
Periodontics
Primary
DE60951176
WA

Other

Enumeration date
10/26/2017
Last updated
04/29/2022
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