Individual
PRAKRUTHI CEGU PHANI RAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
440 W SAM RIDLEY PKWY STE 140, SMYRNA, TN 37167-2999
(615) 768-3242
Mailing address
9199 TRYON CV, CORDOVA, TN 38018-2946
(901) 857-5640
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11676
TN
Other
Enumeration date
08/08/2021
Last updated
08/08/2021
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