Individual
DR. SRI SUDHA BOPPANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
30400 TELEGRAPH RD, BINGHAM FARMS, MI 48025-4537
(248) 901-0718
Mailing address
6845 CARRINGTON CIR E, WEST BLOOMFIELD, MI 48322-2974
(248) 661-3748
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901017958
MI
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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