Individual provider · NPI-1

Durga Buchupally, DDS

Dentist · Bedford, TX

NPI number1669853503
StatusActive
Last updated in NPPESApr 13, 2020

Details

NPI
1669853503
Entity type
Individual (NPI-1)
Name
Durga Buchupally
Credential
DDS
Sex
Female
Sole proprietor
No
Enumeration date
Jun 16, 2015
Certification date
Apr 13, 2020
Last updated
Apr 13, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist30919TXYes

Practice location

2212 Central Dr Ste 101
Bedford, TX 76021-5835

Phone 817-464-8655 · Fax 817-720-9902

Mailing address

940 Saratoga Way
Coppell, TX 75019-6141

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