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Prameela Vennapusala, d.d.s

Dentist in Georgetown, TX. Individual provider (NPI-1).

NPI number1164084554
StatusActive
Last updated in NPPESFeb 12, 2020

Details

NPI
1164084554
Entity type
Individual (NPI-1)
Name
Prameela Vennapusala
Credential
d.d.s
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 5, 2019
Certification date
Feb 12, 2020
Last updated
Feb 12, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist35352TXYes

Practice location

259 Fort Cobb Way
Georgetown, TX 78628-2121

Phone 425-829-4738

Mailing address

259 Fort Cobb Way
Georgetown, TX 78628-2121

Phone 425-829-4738

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