Individual
APARNA GOTTUMUKKULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1106 NEAL AVENUE, JOLIET, IL 60433
(815) 774-7300
Mailing address
4320 CASTLE ROCK CIR, AURORA, IL 60504-8416
(630) 714-9098
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19026611
IL
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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