Ssva1411 LLC

NPI #1922664267 in Richmond, Indiana

Provider Information

NPI Number: 1922664267
Entity Type: Organization
Organization Name: Ssva1411 LLC
Primary Specialty: Dentist
Enumeration Date: May 13, 2019
Last Updated: May 13, 2019

Practice Location

Address: 894 SIM HODGIN PKWY
City: Richmond
State: Indiana
ZIP Code: 47374-1931
Phone: (317) 526-0309

Authorized Official

Name: DR. SHOBA VISWANATHAN, DDS
Title: DENTIST
Phone: (415) 335-5537

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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