Individual
AMITA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 COMMERCE DR STE 600, DECATUR, GA 30030-2619
(404) 373-7818
Mailing address
16 PALMER DR NW, ROME, GA 30165-9515
(706) 266-7175
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123162
GA
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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