# COLUMBIA SURGICAL PROSTHODONTICS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Vanderveen Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629896758
- **Authorized official:** DR. VENKATA GUVVA DDS (OWNER)
- **Authorized official phone:** (419) 819-7450

## Contact information

- **Practice address:** 900 RAIN FOREST PKWY STE A, COLUMBIA, MO 65202-3941
- **Practice address phone:** (573) 443-8100
- **Mailing address:** 19301 E US HIGHWAY 40 STE A, INDEPENDENCE, MO 64055-5572
- **Mailing address phone:** (816) 886-5899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2024
- **Last updated:** 10/11/2024