Individual
DR. DEEPIKA NAIDU THOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1939 ROLAND CLARKE PL STE 120, RESTON, VA 20191-1445
(571) 616-9685
Mailing address
1939 ROLAND CLARKE PL STE 120, RESTON, VA 20191-1445
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
0401418596
VA
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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