Individual
SUFUNPREET GHOTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8028 S EMERSON AVE STE A, INDIANAPOLIS, IN 46237-9301
(317) 648-5527
Mailing address
5528 GREENHILL PL APT J, INDIANAPOLIS, IN 46237-7403
(929) 519-2429
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014154A
IN
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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