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General NPI Number Information
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NPI Number | 1790949410
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Entity Type | Organization
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Legal Business Name | DR. RESHMA GOWDA P.C.
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 2950 E WATTLES RD # 200
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City | TROY
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State | MI
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Zip | 48085-7008
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Country | US
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Telephone | 248-526-9680
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Fax | 248-526-9682
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Provider Business Mailing Address
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Address Line | 2950 E WATTLES RD # 200
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City | TROY
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State | MI
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Zip | 48085-7008
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Country | US
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Telephone | 248-526-9680
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Fax | 248-526-9682
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Authorized Official
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Title or Position | DDS
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Name | RESHMA GOWDA
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Credential | DDS
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Telephone | 248-526-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17968
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License Number State | MI
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