Individual
SUGANDHA MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1820 N 75TH AVE, PHOENIX, AZ 85035-4533
(623) 255-3607
Mailing address
4950 E VAN BUREN ST APT 328, PHOENIX, AZ 85008-7050
(646) 264-8736
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009307
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2015
Last updated
07/17/2015
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