Srivarsha Ponna
NPI #1093367153 in Bossier City, Louisiana
Provider Information
- NPI Number
- 1093367153
- Entity Type
- Individual
- Name
- Srivarsha Ponna
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Jul 9, 2019
- Last Updated
- Nov 29, 2022
Practice Location
- Address
- 2285 BENTON RD STE C100
- City
- Bossier City
- State
- Louisiana
- ZIP Code
- 71111-3465
- Phone
- (318) 742-9333
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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