Individual
SARITHA GAJAWADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15354 PLUMSTONE DR, EDEN PRAIRIE, MN 55347-2061
(612) 244-3143
Mailing address
15354 PLUMSTONE DR, EDEN PRAIRIE, MN 55347-2061
(612) 244-3143
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT85
MN
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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