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Individual

PRABHA R RAJU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
1024 N GENESEE RD, BURTON, MI 48509-1433
(810) 715-3368
(810) 715-1663
Mailing address
1024 N GENESEE RD, P O BOX 90161, BURTON, MI 48509-1433
(810) 715-3368
(810) 715-1663

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15924
MI

Other

Enumeration date
04/09/2008
Last updated
04/09/2008
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