Individual
DR. PRASAD CHALLAGULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
821 S 9TH ST, PHILADELPHIA, PA 19147-2822
(215) 629-0599
Mailing address
821 S 9TH ST, PHILADELPHIA, PA 19147-2822
(215) 629-0599
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS037224
PA
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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