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Manogna Deepthi Yakasiri
General Practice Dentistry in Mount Vernon, Illinois
NPI 1659927515

Manogna Deepthi Yakasiri is a General Practice Dentistry based in Mount Vernon, IL and is specialized in General Practice. Manogna Deepthi Yakasiri practices in Mount Vernon, IL. The NPI Number for Manogna Deepthi Yakasiri is 1659927515 and holds a License No. 019032341 (Illinois).

The current practice location address for Manogna Deepthi Yakasiri is 4201 Broadway St Ste C, Mount Vernon, IL and can be reached out via phone at 618-241-0353.

Location: 4201 Broadway St Ste C, Mount Vernon, IL, 62864-2344
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659927515
Provider Name
Manogna Deepthi Yakasiri
Credential
Provider Entity Type
Individual
Gender
Female
Address
4201 Broadway St Ste C, Mount Vernon, IL, 62864-2344
Phone Number
618-241-0353
Fax Number
Provider Enumeration Date
08/15/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4201 Broadway St Ste C
City
Mount Vernon
State
Illinois
Zip
62864-2282
Phone Number
618-241-0353
Fax Number
person
Provider Business Mailing Address Details
Address
4201 Broadway St Ste C
City
Mount Vernon
State
Illinois
Zip
62864-2282
Phone Number
618-241-0353
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
019032341 (Illinois)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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