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General NPI Number Information
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NPI Number | 1821430919
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Entity Type | Individual
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Provider Name | ANUKAMPA DUTT DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 19115 PRESCOTT OAKS
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 503-621-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 19115 PRESCOTT OAKS
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3851
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Country | US
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Telephone | 503-621-6000
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 28766
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License Number State | TX
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