Individual
DR. PRASANNA RAVURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
999 SUMMER ST, SUITE 306, STAMFORD, CT 06905-5546
(203) 356-9990
Mailing address
999 SUMMER ST, SUITE 306, STAMFORD, CT 06905-5546
(203) 356-9990
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
010278
CT
1223G0001X
General Practice Dentistry
Primary
010278
CT
Other
Enumeration date
06/30/2010
Last updated
08/05/2020
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