Individual
YAGNA ROOPA KASARANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4512 PARNELL AVE, FORT WAYNE, IN 46825-5836
(260) 238-8899
Mailing address
13728 LEDGESTONE PL, FORT WAYNE, IN 46814-0057
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013829A
IN
Other
Enumeration date
06/09/2022
Last updated
10/29/2022
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