Individual
KIRANKUMAR TAMMINIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4017 N PRINCE ST, CLOVIS, NM 88101-9705
(575) 762-2757
Mailing address
35 NORTHAMPTON ST APT 2608, BOSTON, MA 02118-4022
(617) 784-4183
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3718
NM
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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