Individual
THULASISWARNALATHA MUPPURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3590 BRASELTON HWY STE 201, DACULA, GA 30019-1120
(678) 714-7575
Mailing address
2565 SANDOWN CT, CUMMING, GA 30041-1589
(609) 529-8935
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10318
CT
1223G0001X
General Practice Dentistry
Primary
DN016017
GA
Other
Enumeration date
07/23/2010
Last updated
09/10/2021
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