DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. GANGADHAR IMMANNI, DDS

Active

DR. GANGADHAR IMMANNI, DDS is a General Dentistry healthcare provider located in PORTALES, New Mexico. NPI 1912285032 is currently active in the NPPES registry. Verify at CMS.

General Dentistry · PORTALES, NM

Registration Details

NPI Number
1912285032
Provider Type
Individual
Gender
Male
NPI Issued
Jul 22, 2011 (15.062905052868 yrs)
Last Updated
Nov 13, 2012
License
DD3547 (NM)

Practice Information

Address
1515 WEST FIR
PORTALES, NM, 88130
Browse NM providers · Browse ZIP 88130
Phone
5753566695
Fax
5753565948
Primary Specialty
General Dentistry
1223G0001X

Other General Dentistry Providers in PORTALES, NM

Name Credential NPI
DR. PETER L THOMPSON D.D.S. 1255444295
AARON MARK STANDING DMD 1427570357
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.