| Praveen Pavuluru, Dmd, Llc | |
|
90 Ridgewood Dr Bangor ME 04401-2652 | |
| (207) 262-3744 | |
| (207) 262-3745 |
| Full Name | Praveen Pavuluru, Dmd, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 90 Ridgewood Dr, Bangor, Maine |
| Authorized Official Name and Position | Praveen K Pavuluru (SOLE OWNER/MEMBER) |
| Authorized Official Contact | 2075773424 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Praveen Pavuluru, Dmd, Llc 90 Ridgewood Dr Bangor ME 04401-2652 Ph: (207) 262-3744 | Praveen Pavuluru, Dmd, Llc 90 Ridgewood Dr Bangor ME 04401-2652 Ph: (207) 262-3744 |
| NPI Number | 1962133454 |
|---|---|
| Provider Enumeration Date | 06/23/2022 |
| Last Update Date | 06/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962133454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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