Sushma Mangalavarapet Kantharaju, D.D.S
Dentist in Stockton, CA. Individual provider (NPI-1).
NPI number1982155834
StatusActive
Last updated in NPPESOct 16, 2016
Details
- NPI
- 1982155834
- Entity type
- Individual (NPI-1)
- Name
- Sushma Mangalavarapet Kantharaju
- Credential
- D.D.S
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 16, 2016
- Last updated
- Oct 16, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DDS100731 | CA | Yes |
Practice location
4053 E Morada LnStockton, CA 95212-1608
Phone 209-478-6000
Mailing address
4053 E Morada LnStockton, CA 95212-1608
Phone 209-478-6000
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