Organization
REDDY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NISHANTH REDDY PUCHALAPALLI DDS (MANAGING MEMBER)
(408) 306-8365
Entity
Organization
Contact information
Practice address
3218 N GRIMES ST, HOBBS, NM 88240-1254
(575) 396-4074
Mailing address
617 W COTTONWOOD AVE, LOVINGTON, NM 88260-2652
(408) 306-8365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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