Individual
GEETHA MUTHUKURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7130 W GREENFIELD AVE, WEST ALLIS, WI 53214-4708
(414) 258-2500
Mailing address
1518 DEWBERRY DR, MADISON, WI 53719-4414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6655-015
WI
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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