SearchIllinois122300000X

Sandeep Thota

NPI 1467835223 · on the registry since 2015

Practice

Address
1407 N Veterans Pkwy
Bloomington, IL 61704
Phone
(314) 651-6550
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
122300000X
122300000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2015-06-29

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