Individual
MITTIDA RAKSANAVES
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
1320 W INA RD, TUCSON, AZ 85704-3115
(520) 742-1232
Mailing address
1320 W INA RD, TUCSON, AZ 85704-3115
(520) 742-1232
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4337
AZ
Other
Enumeration date
07/08/2005
Last updated
07/08/2007
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