Individual
LAKSHMI MYLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 E GROVERS AVE, UNIT 23, PHOENIX, AZ 85022-1918
(571) 528-8455
Mailing address
815 E GROVERS AVE, UNIT 23, PHOENIX, AZ 85022-1918
(571) 528-8455
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009611
AZ
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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