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Individual

DR. VIJAYA LAKSHMI PAVAN MOLLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4021 REGGIS CT STE 313, FORT WORTH, TX 76155-3958
(817) 764-1496
(817) 997-4342
Mailing address
2701 W ROYAL LANE, APT 805, IRVING, TX 75063
(817) 764-1496
(817) 997-4342

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
37900
TX

Other

Enumeration date
09/22/2021
Last updated
02/24/2022
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