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Individual

DR. SIMHA VAIBHAVA REDDY KUKUNOORU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
B.D.S

Contact information

Practice address
1799 66TH ST N, ST PETERSBURG, FL 33710-5537
(727) 222-3220
Mailing address
1799 66TH ST N, ST PETERSBURG, FL 33710-5537
(205) 807-6322

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN19262
FL

Other

Enumeration date
10/07/2010
Last updated
07/08/2024
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