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Individual

DR. USHA POLAVARAPU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1152 CLINTON AVENUE, IRVINGTON, NJ 07111
(973) 372-5640
(973) 371-7697
Mailing address
1152 CLINTON AVENUE, IRVINGTON, NJ 07111
(973) 372-5640
(973) 371-7697

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19126
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7421109
NJ
Enumeration date
02/28/2007
Last updated
02/15/2012
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