Individual
ANIL P NUTAKKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1840 FOLSOM ST STE 301, BOULDER, CO 80302-5712
(303) 443-1146
Mailing address
1840 FOLSOM ST STE 301, BOULDER, CO 80302-5712
(303) 443-1146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
202087
CO
Other
Enumeration date
04/30/2012
Last updated
08/01/2016
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