Individual
KARTHIKA BASIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 EXECUTIVE DR, LAFAYETTE, IN 47905-4878
(270) 935-9001
Mailing address
1221 BURBERRY DR W APT 50, LAFAYETTE, IN 47905-4993
(270) 935-9001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013250A
IN
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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