Individual
ANIL KUMAR REDDY MANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5020 WEST LLOYD EXPWY, STE 200, EVANSVILLE,, IN 47712
(812) 463-8000
(812) 463-8104
Mailing address
PO BOX 3189, SYRACUSE, NY 13220
(866) 273-8204
(866) 803-4943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011176A
IN
Other
Enumeration date
07/24/2008
Last updated
07/24/2008
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