Individual
RATNAKAR MANDAVA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1302 S MAIN ST, WATERBURY, CT 06706-1748
(203) 756-8021
Mailing address
1314 TOWN COLONY DR, MIDDLETOWN, CT 06457-5935
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
009395
CT
Other
Enumeration date
08/11/2005
Last updated
07/08/2007
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