Individual
DR. ANISHA KRISHNAN THONDUKOLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
591 FALLEN LEAF CIR, SAN RAMON, CA 94583-5305
(510) 604-5776
Mailing address
591 FALLEN LEAF CIR, SAN RAMON, CA 94583-5305
(510) 604-5776
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
62123
CA
Other
Enumeration date
09/08/2009
Last updated
04/01/2013
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