# REDDY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619648342
- **Authorized official:** DR. NISHANTH REDDY PUCHALAPALLI DDS (MANAGING MEMBER)
- **Authorized official phone:** (408) 306-8365

## Contact information

- **Practice address:** 3218 N GRIMES ST, HOBBS, NM 88240-1254
- **Practice address phone:** (575) 396-4074
- **Mailing address:** 617 W COTTONWOOD AVE, LOVINGTON, NM 88260-2652
- **Mailing address phone:** (408) 306-8365

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/22/2021
- **Last updated:** 09/22/2021