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General NPI Number Information
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NPI Number | 1265997712
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Entity Type | Individual
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Provider Name | BHAVANI S ACHUNALA DDS
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Gender | Female
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | N6571 LUMBERJACK GUY RD
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City | BLACK RIVER FALLS
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State | WI
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Zip | 54615-5405
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Country | US
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Telephone | 715-387-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 581 TIMBER CREEK CIR
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City | BLACK RIVER FALLS
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State | WI
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Zip | 54615-8108
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Country | US
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Telephone | 419-819-6156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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