Sandeep Thota
NPI #1467835223 in Bloomington, Illinois
Provider Information
- NPI Number
- 1467835223
- Entity Type
- Individual
- Name
- Sandeep Thota
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Enumeration Date
- Jun 29, 2015
- Last Updated
- Jun 29, 2015
Practice Location
- Address
- 1407 N VETERANS PKWY
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-6630
- Phone
- (314) 651-6550
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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