Individual
ANITA R MADDALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
47 BURNSIDE AVE, EAST HARTFORD, CT 06108-3405
(860) 899-1360
Mailing address
47 BURNSIDE AVE, EAST HARTFORD, CT 06108-3405
(860) 899-1361
(860) 899-1361
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
21759MA
MA
1223G0001X
General Practice Dentistry
Primary
9481
CT
Other
Enumeration date
02/05/2007
Last updated
01/03/2020
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