Individual
VENKATA MOHAN K MUTNURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1141 KELLER PKWY STE B, KELLER, TX 76248-1628
(817) 753-0226
Mailing address
880 S COIT RD APT 905, PROSPER, TX 75078-3011
(201) 970-0273
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
37586
TX
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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