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Individual

DR. SUPRIYA GOVERDHANAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BDS, MS

Contact information

Practice address
291 C ST UNIT 112, WASHOUGAL, WA 98671-2168
(734) 846-5153
Mailing address
291 C ST UNIT 112, WASHOUGAL, WA 98671-2168
(734) 846-5153

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00010217
WA

Other

Enumeration date
04/25/2007
Last updated
08/28/2008
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