Individual
DR. HARISHA TIRUKKOVALLURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3114 QUEENS CHAPEL RD, HYATTSVILLE, MD 20782-3665
(201) 257-7095
Mailing address
24625 GREYSTEEL SQ, ALDIE, VA 20105-2793
(781) 249-2017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401416621
VA
122300000X
Dentist
Primary
16036
MD
122300000X
Dentist
DEN1001826
DC
Other
Enumeration date
07/06/2016
Last updated
09/24/2021
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