Individual
TIRUMALA AGGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6100 WASHINGTON AVE STE F2, MOUNT PLEASANT, WI 53406-4000
(262) 999-9998
Mailing address
2655 SHOWPLACE DR UNIT 101, NAPERVILLE, IL 60564-3334
(860) 595-8906
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.032279
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100189811
—
WI
Enumeration date
06/11/2019
Last updated
01/04/2024
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