Individual
MANJUSHA KUPPADAKATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32530 SHIELA WAY, UNION CITY, CA 94587-5048
(408) 313-6090
Mailing address
32530 SHIELA WAY, UNION CITY, CA 94587-5048
(408) 313-6090
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
26210
CA
124Q00000X
Dental Hygienist
Primary
HAP891
CA
Other
Enumeration date
03/01/2022
Last updated
04/27/2022
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