Individual
DR. MANASA KANNEGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1738 W NORTH AVE, CHICAGO, IL 60622-2147
(773) 276-5566
Mailing address
513 S DAMEN AVE APT 710, CHICAGO, IL 60612-5592
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.034523
IL
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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