Provider Demographics
NPI:1073366373
Name:EMPERUMAL, CHITRA PRIYA (BDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CHITRA PRIYA
Middle Name:
Last Name:EMPERUMAL
Suffix:
Gender:F
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3475 PLYMOUTH BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1539
Mailing Address - Country:US
Mailing Address - Phone:763-577-2484
Mailing Address - Fax:763-577-1375
Practice Address - Street 1:3475 PLYMOUTH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-1539
Practice Address - Country:US
Practice Address - Phone:763-577-2484
Practice Address - Fax:763-577-1375
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNS1921223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain