Individual
AISHWARYA SUBRAMANIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22202 N CAVE CREEK RD, PHOENIX, AZ 85024-7599
(480) 616-2222
Mailing address
1675 E MORTEN AVE UNIT 2139, PHOENIX, AZ 85020-4687
(813) 728-7679
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011043
AZ
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/18/2020
Last updated
12/30/2021
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