Individual
SUMAN CHENNADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 N BRIDGE ST, SOMERVILLE, NJ 08876-2110
(908) 725-0400
Mailing address
15 N BRIDGE ST, SOMERVILLE, NJ 08876-2110
(908) 725-0400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02614400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22DI02614400
NJ DENTAL BOARD
NJ
Enumeration date
10/13/2015
Last updated
10/13/2015
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