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Individual

PRATHIMA SREE PRASANNA VEMULAPALLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD, MMSC

Contact information

Practice address
188 LONGWOOD AVE, REB 203, BOSTON, MA 02115-5819
(617) 283-6428
(617) 432-7319
Mailing address
2727 REVERE ST, #3002, HOUSTON, TX 77098-1328
(617) 283-6428

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
21677
MA

Other

Enumeration date
03/13/2008
Last updated
03/02/2010
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