Srinivasulu Kakollu, D.D.S
NPI 1265744189 · on the registry since 2010
Practice
- Address
- 1407 N Veterans Pkwy Ste 12
Bloomington, IL 61704 - Phone
- (732) 379-0953
- Organisation at this address
- Lakewood Family Dental
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-03-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois