Individual
SWATHI GOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3113 S 13TH ST, MILWAUKEE, WI 53215-4609
(414) 808-2003
Mailing address
3113 S 13TH ST, MILWAUKEE, WI 53215-4609
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001660
WI
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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