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Dr. Sriram V Myneni, DDS

Dentist, General Practice in Manchester, CT. Individual provider (NPI-1).

NPI number1144320367
StatusActive
Last updated in NPPESApr 2, 2024

Details

NPI
1144320367
Entity type
Individual (NPI-1)
Name
Dr. Sriram V Myneni
Credential
DDS
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 25, 2006
Certification date
Apr 2, 2024
Last updated
Apr 2, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice010590CTYes

Practice location

935 Main St
Suite # B2
Manchester, CT 06040-6059

Phone 860-643-0011

Mailing address

935 Main St Ste B2
Manchester, CT 06040-6050

Phone 860-643-0011 · Fax 860-646-8548

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