Organization
LAKE LANIER SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVEEN REDDY GUDIPATI (DENTIST OWNER)
(770) 205-0466
Entity
Organization
Contact information
Practice address
4965 LANIER ISLANDS PKWY, SUITE 105, BUFORD, GA 30518-1700
(770) 831-0559
Mailing address
4965 LANIER ISLANDS PKWY, SUITE 105, BUFORD, GA 30518-1700
(770) 831-0559
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2016
Last updated
05/12/2025
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