Organization
SAI ORAL SURGERY
Active
Organization
SAI ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRAVANTHI GANNE DDS MD (PRESIDENT)
(412) 913-8877
Entity
Organization
Contact information
Practice address
1728 DUNLAWTON AVE, SUITE 3, PORT ORANGE, FL 32127-2922
(412) 913-8877
Mailing address
1728 DUNLAWTON AVE, SUITE 3, PORT ORANGE, FL 32127-2922
(412) 913-8877
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DN19304
FL
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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