Individual
DR. KRISHNAPRASANTH MUDUSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 STATE ST, SPRINGFIELD, MA 01109-4101
(413) 736-0027
Mailing address
555 STATE ST, SPRINGFIELD, MA 01109-4101
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855282
MA
Other
Enumeration date
10/26/2009
Last updated
10/26/2009
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