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General NPI Number Information
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NPI Number | 1508038712
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Entity Type | Organization
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Legal Business Name | SARAT NALLURI, DDS, INC.
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 7067 TIFFANY BLVD STE 260
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City | POLAND
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State | OH
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Zip | 44514-1958
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Country | US
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Telephone | 330-629-9021
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Fax | 330-965-9237
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Provider Business Mailing Address
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Address Line | 7067 TIFFANY BLVD STE 260 P.O. BOX 5410
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City | POLAND
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State | OH
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Zip | 44514-1958
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Country | US
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Telephone | 330-629-9021
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Fax | 330-965-9237
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SARAT NALLURI
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Credential | D.D.S.
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Telephone | 330-629-9021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30020901
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License Number State | OH
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