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Individual

MADHUMEETA SANAM-VENKATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
11180 GRATIOT AVE, DETROIT, MI 48213-1363
(313) 925-3090
Mailing address
24419 WILLOWBROOK, NOVI, MI 48375-3572

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2901600559
MI
1223G0001X
General Practice Dentistry
Primary
2901600559
MI

Other

Enumeration date
07/08/2020
Last updated
07/14/2020
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