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Individual

DR. DHEERAJ PAMIDIMUKKALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
315 AUBURN ST, PORTLAND, ME 04103-2179
(207) 797-5000
Mailing address
100 CLEARWATER DR, #75, FALMOUTH, ME 04105-1317
(617) 642-9775

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3824
ME

Other

Enumeration date
09/14/2006
Last updated
07/08/2007
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