Individual
DR. SHANTI SMITHA TELIKICHERLA KANDALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 854-2122
(508) 854-2122
Mailing address
650 LINCOLN ST, WORCESTER, MA 01605-2060
(508) 852-1805
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DL12643
MA
122300000X
Dentist
Primary
DL13493
MA
Other
Enumeration date
07/23/2015
Last updated
03/17/2018
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