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Individual

KRISHNA P KANSAGRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1500 LOCUST ST APT 3602, PHILADELPHIA, PA 19102-4324
(909) 670-7777
Mailing address
15389 CANON LN, CHINO HILLS, CA 91709-5239
(909) 670-7777

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
64979
CA
122300000X
Dentist
DS042127
PA
1223P0221X
Pediatric Dentistry
Primary
64979
CA

Other

Enumeration date
09/28/2015
Last updated
09/15/2020
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