Individual
SUPRIYA K SHETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
21675 LONGVIEW DR, WAUKESHA, WI 53186-2010
(262) 798-8870
(262) 798-8810
Mailing address
21675 LONGVIEW DR, WAUKESHA, WI 53186-2010
(262) 798-8870
(262) 798-8810
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5914
WI
Other
Enumeration date
07/19/2005
Last updated
07/08/2007
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