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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