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General NPI Number Information
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NPI Number | 1467023002
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Entity Type | Individual
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Provider Name | POOJA YARLAGADDA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 16201 FORD RD
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City | DEARBORN
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State | MI
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Zip | 48126-2945
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Country | US
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Telephone | 773-456-7071
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Fax |
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Provider Business Mailing Address
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Address Line | 29748 CITATION CIR APT 30202
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City | FARMINGTON HILLS
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State | MI
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Zip | 48331-5847
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Country | US
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Telephone | 716-331-6973
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901601017
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License Number State | MI
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