Individual
SUNIL KUMAR REDDY GUDDETI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
6330 RIVERSIDE PLAZA LN NW STE 165, ALBUQUERQUE, NM 87120
(571) 484-3008
(505) 639-4684
Mailing address
153 LACUESTA CT NE, RIORANCHO, NM 87124-6383
(571) 484-3008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
29647
TX
1223G0001X
General Practice Dentistry
Primary
DD4236
NM
1223G0001X
General Practice Dentistry
DS039583
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54501334
—
NM
Enumeration date
06/27/2013
Last updated
06/27/2018
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