Supraja Mundla is a General Practice in Canton, Michigan. Supraja Mundla practices all healthcare services and medical treatments related to General Practice. The NPI Number for Supraja Mundla is 1770637688. The last update date is 2022-01-21.
Supraja Mundla's current location address is 5970 N Lilley Rd, Canton, Michigan. You can contact this provider via phone number 7349815455. The mailing address for Supraja Mundla is 5970 N Lilley Rd, Canton, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Supraja Mundla |
|---|---|
| Address | 5970 N Lilley Rd, Canton, Michigan |
| Phone Number | 7349815455 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1770637688 |
|---|---|
| Provider Enumeration Date | 2007-01-22 |
| Last Updated Date | 2022-01-21 |
Provider Mailing Address Detail
| Address | 5970 N Lilley Rd |
|---|---|
| City | Canton |
| State | Michigan (MI) |
| Post Code | 481873625 |
| Phone Number | 7349815455 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 2901018754 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique identifier code issued to Supraja Mundla by the Centers for Medicare & Medicaid Services (CMS)?
The Supraja Mundla has been assigned the NPI (National Provider Identifier) 1770637688. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you kindly provide the complete physical address where Supraja Mundla's facilities are geographically located?
The facilities of Supraja Mundla are physically situated at the following location: 5970 N Lilley Rd, Canton, MI, 481873625.
What is Supraja Mundla's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Supraja Mundla is General Practice, and the taxonomy code that classifies this field of practice is 1223G0001X.
On what date did the Supraja Mundla receive its 1770637688 assignment from the Centers for Medicare & Medicaid Services?
The Supraja Mundla was assigned its 1770637688 by the Centers for Medicare & Medicaid Services on 2007-01-22.
As of what date were the details related to Supraja Mundla most recently updated or revised?
The information pertaining to Supraja Mundla, including its address, specialty, and other relevant details, was last updated or revised on 2022-01-21.
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