Individual
DR. LAHARI VATTIKUNTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.D.S, M.S, PHD
Contact information
Practice address
765 N ASPEN AVE, BROKEN ARROW, OK 74012-2224
(918) 451-2717
Mailing address
765 N ASPEN AVE, BROKEN ARROW, OK 74012-2224
(918) 451-2717
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
86
OK
Other
Enumeration date
11/23/2021
Last updated
11/09/2023
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