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Individual

DR. ANALA PANCHUMARTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
4714 N ARMENIA AVE, SUITE 102, TAMPA, FL 33603-2603
(813) 876-1200
Mailing address
4714 N.ARMENIA AVE, SUITE 102, TAMPA, FL 33603
(813) 876-1200

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN 18085
FL
1223G0001X
General Practice Dentistry
Primary
22227
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
175189301
TX
Enumeration date
04/08/2006
Last updated
10/05/2012
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