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Individual

MRS. GODA DEVI SUBHA HAJEEBU VENKATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
11606 NW48TH STREET, CORAL SPRINGS, FL 33076
(954) 415-2098
Mailing address
11606 NW 48TH ST, CORAL SPRINGS, FL 33076-3525
(954) 415-2098

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19920
FL

Other

Enumeration date
11/02/2012
Last updated
11/02/2012
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