Provider Demographics
NPI:1346884137
Name:HORALEK, MUDALAPURAM AND ASSOCIATES, PC
Entity Type:Organization
Organization Name:HORALEK, MUDALAPURAM AND ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PRATHIBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUDALAPURAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-355-5510
Mailing Address - Street 1:102 FINSBURY ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8205
Mailing Address - Country:US
Mailing Address - Phone:631-880-9449
Mailing Address - Fax:
Practice Address - Street 1:346 SEMBLER LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-2609
Practice Address - Country:US
Practice Address - Phone:919-297-2701
Practice Address - Fax:919-297-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty