Individual
DR. POORNIMA JAYAPRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6218 WASHINGTON AVE, SUITE C, RACINE, WI 53406-3916
(262) 886-1300
(262) 886-1837
Mailing address
6218 WASHINGTON AVE, SUITE C, RACINE, WI 53406-3916
(262) 886-1300
(262) 886-1837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4048
WI
Other
Enumeration date
01/01/2007
Last updated
07/08/2007
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