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Dr. Gangadhar Immanni, DDS
General Practice Dentistry in Portales, New Mexico
NPI 1912285032

Gangadhar Immanni is a General Practice Dentistry based in Portales, NM and is specialized in General Practice. Gangadhar Immanni practices in Portales, NM and has the professional credentials of DDS. The NPI Number for Gangadhar Immanni is 1912285032 and holds a License No. DD3547 (New Mexico).

The current practice location address for Gangadhar Immanni is 1515 West Fir, Portales, NM and can be reached out via phone at 575-356-6695 and via fax at 575-356-5948.

Location: 1515 West Fir, Portales, NM, 88130
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912285032
Provider Name
Gangadhar Immanni
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1515 West Fir, Portales, NM, 88130
Phone Number
575-356-6695
Fax Number
575-356-5948
Provider Enumeration Date
07/22/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1515 West Fir
City
Portales
State
New Mexico
Zip
88130
Phone Number
575-356-6695
Fax Number
575-356-5948
person
Provider Business Mailing Address Details
Address
1515 West Fir
City
Portales
State
New Mexico
Zip
88130
Phone Number
575-356-6695
Fax Number
575-356-5948
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DD3547 (New Mexico)
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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