Individual
DR. LAKSHMI MANASA NALLAMOTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
14155 N 83RD AVE STE 113, PEORIA, AZ 85381-5655
(602) 626-3985
Mailing address
14155 N 83RD AVE STE 113, PEORIA, AZ 85381-5655
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11219
AZ
1223G0001X
General Practice Dentistry
Primary
12067
NC
Other
Enumeration date
09/29/2020
Last updated
05/11/2022
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