Organization
REDWOOD SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEERTHI GOLLA DMD (DENTIST)
(650) 369-3695
Entity
Organization
Contact information
Practice address
160 BIRCH ST, REDWOOD CITY, CA 94062-1307
(650) 369-3695
Mailing address
PO BOX 340129, SACRAMENTO, CA 95834-0129
(916) 419-9939
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
100398
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100398
DENTAL LICENSE
CA
Enumeration date
03/28/2017
Last updated
03/28/2017
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