Individual
DR. MAHENDRA PARVATHA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1407 W 84TH AVE UNIT B8, DENVER, CO 80260-4753
(720) 214-4746
(720) 214-4745
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
203806
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215437389
—
CO
01
—
DEN.00203806
CO DENTAL LICENSE
CO
Enumeration date
02/15/2018
Last updated
06/18/2019
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