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General NPI Number Information
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NPI Number | 1881453058
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Entity Type | Organization
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Legal Business Name | KRISHNA NEELAGIRI DDS INC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 536 ESTUDILLO AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4612
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Country | US
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Telephone | 510-483-2244
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Fax | 510-483-0825
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Provider Business Mailing Address
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Address Line | 536 ESTUDILLO AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4612
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Country | US
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Telephone | 510-483-2244
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Fax | 510-483-0825
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | KRISHNA NEELAGIRI
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Credential | DDS
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Telephone | 408-802-5270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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