Individual
MS. KAVYA SHANKAR MUTTANAHALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
UCONN SCHOOL OF DENTAL MEDICINE 263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2952
Mailing address
33 LAKESHORE DR APT B2, FARMINGTON, CT 06032-1268
(860) 725-2104
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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