Shuba Anantha, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Gurnee, IL

NPI

1346239902

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

019026565 (IL)

Sex

Female

Sole proprietor

Yes

Enumerated

2005-10-17

Last updated

2010-04-28