Individual
ANILA MARY PORAVANTHATTIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
22986 E SMOKY HILL RD # 80016, AURORA, CO 80016-1382
(303) 690-1690
Mailing address
7575 E 29TH PL APT 1119, DENVER, CO 80238-4035
(510) 990-5322
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
00204760
CO
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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