Provider Demographics
NPI:1114446986
Name:ANIL VUGGAM DMD PLLC
Entity Type:Organization
Organization Name:ANIL VUGGAM DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:VUGGAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:857-205-5176
Mailing Address - Street 1:124 FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:TX
Mailing Address - Zip Code:79821
Mailing Address - Country:US
Mailing Address - Phone:857-205-5176
Mailing Address - Fax:
Practice Address - Street 1:124 FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:TX
Practice Address - Zip Code:79821
Practice Address - Country:US
Practice Address - Phone:857-205-5176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty