Individual
VENKATA VELAGAPUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 HAZARD AVE, DR .DENTAL, ENFIELD, CT 06082-3845
(972) 974-9926
(860) 745-8804
Mailing address
155 WINDERMERE AVE, UNIT # 3005, ELLINGTON, CT 06029-5800
(972) 974-9926
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011512
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011512
CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ( DENTAL LICENCE)
CT
Enumeration date
09/28/2015
Last updated
04/28/2016
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