Organization
KISHORE THAMMINENI DENTAL ASSOCIATES DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KISHORE BABU THAMMINENI DDS (OWNER)
(305) 942-3458
Entity
Organization
Contact information
Practice address
20876 ISHERWOOD TER APT 101, ASHBURN, VA 20147-7788
(305) 942-3458
(540) 773-3284
Mailing address
1330 AMHERST ST STE B, WINCHESTER, VA 22601-3000
(305) 942-3458
(540) 773-3284
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414079
VA
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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