Individual
SUPRIYA GANUPUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
3050 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30311-1500
(404) 696-3163
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019027769
IL
1223G0001X
General Practice Dentistry
Primary
DN013812
GA
Other
Enumeration date
07/28/2008
Last updated
12/28/2010
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