Individual
RHIANNON MARIE KURUPPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1240 CEDAR CT, CARBONDALE, IL 62901-5334
(618) 549-7621
Mailing address
1240 CEDAR CT, CARBONDALE, IL 62901-5334
(618) 549-7621
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034286
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2023
Last updated
12/27/2023
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