Individual
DR. SOUMYA IMMELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1536 CROSSLAND RD, BREINIGSVILLE, PA 18031-1471
(484) 934-2305
(610) 435-7606
Mailing address
750 N KROCKS RD STE 206, ALLENTOWN, PA 18106-9079
(610) 530-7785
(610) 435-7606
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS042399
PA
Other
Enumeration date
11/04/2019
Last updated
03/01/2024
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