Individual
REKHA RETHIYAMMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2332 MIRACLE LN, MISHAWAKA, IN 46545-3012
(574) 259-5437
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
(719) 583-1801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9108
KY
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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