Individual
DR. LIKITH V REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D
Contact information
Practice address
3302 GASTON AVE, RM #161, DALLAS, TX 75246-2013
(214) 828-8455
(214) 828-8382
Mailing address
PO BOX 660677, RM 177, DALLAS, TX 75266-0677
(214) 828-8455
(214) 874-4527
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
Q0158
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2414097
—
OH
05
—
2554294
—
OH
Enumeration date
03/31/2006
Last updated
05/07/2014
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