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General NPI Number Information
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NPI Number | 1750097804
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Entity Type | Organization
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Legal Business Name | REDDY AND REDDY DENTAL CORPORATION
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 4533 COLLEGE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92115-4010
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Country | US
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Telephone | 619-380-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 4533 COLLEGE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92115-4010
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Country | US
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Telephone | 619-380-2828
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DR. RAMDEEPAK N REDDY
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Credential | DDS
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Telephone | 760-402-0529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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