Individual
DR. AMAR KOSARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1615 TRUEMPER ST, DUNN DENTAL CLINIC, RM B227, JBSA LACKLAND, TX 78236
(210) 292-0774
Mailing address
1615 TRUEMPER ST, DUNN DENTAL CLINIC, RM B227, JBSA LACKLAND, TX 78236
(210) 292-0774
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
058340
NY
1223G0001X
General Practice Dentistry
Primary
DS-031024L
PA
Other
Enumeration date
10/04/2005
Last updated
08/05/2020
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