Organization
VIRAJITHA VELICHALA DDS PC
Active
Other names
MARVEL DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRAJITHA VELICHALA DDS (PRESIDENT)
(216) 801-2718
Entity
Organization
Contact information
Practice address
2880 WALMART DR UNIT 2920, HUNTINGTON, IN 46750-7977
(216) 801-2718
Mailing address
11516 PRATO CV, FORT WAYNE, IN 46845-1385
(216) 801-2718
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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