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General NPI Number Information
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NPI Number | 1760752869
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Entity Type | Organization
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Legal Business Name | REDDY PEDIATRIC DENTISTRY, P.C.
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 274 SOUTH COLLINS ROAD
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City | SUNNYVALE
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State | TX
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Zip | 75182
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Country | US
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Telephone | 972-329-5437
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Fax | 972-329-5436
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Provider Business Mailing Address
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Address Line | 274 SOUTH COLLINS ROAD
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City | SUNNYVALE
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State | TX
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Zip | 75182
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Country | US
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Telephone | 972-329-5437
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Fax | 972-329-5436
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. ANIL KUMAR REDDY
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Credential | DDS.
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Telephone | 214-213-8966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 17965
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License Number State | TX
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