Provider Demographics
NPI:1437249562
Name:KESARI, PREETHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:PREETHA
Middle Name:
Last Name:KESARI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:FRAZER
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1834
Mailing Address - Country:US
Mailing Address - Phone:610-993-0444
Mailing Address - Fax:
Practice Address - Street 1:480 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FRAZER
Practice Address - State:PA
Practice Address - Zip Code:19355-1834
Practice Address - Country:US
Practice Address - Phone:610-993-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS28145L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice