Individual
KINNARA VASAMSETTI EMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2754 MAYBANK HWY, JOHNS ISLAND, SC 29455-4809
(843) 559-5555
Mailing address
2754 MAYBANK HWY, JOHNS ISLAND, SC 29455-4809
(843) 559-5555
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9420
SC
Other
Enumeration date
07/12/2019
Last updated
12/01/2020
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