Provider Demographics
NPI:1619128527
Name:GUNDABATHULA, SINDHU
Entity Type:Individual
Prefix:DR
First Name:SINDHU
Middle Name:
Last Name:GUNDABATHULA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 LIMEKILN PIKE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3602
Mailing Address - Country:US
Mailing Address - Phone:215-997-4434
Mailing Address - Fax:215-997-4436
Practice Address - Street 1:3425 LIMEKILN PIKE
Practice Address - Street 2:SUITE 5
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3602
Practice Address - Country:US
Practice Address - Phone:215-997-4434
Practice Address - Fax:215-997-4436
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037666122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist