Individual
DR. SOUMYA PADALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BDS, MDS, MS
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-0001
(706) 721-2371
(706) 721-6778
Mailing address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-0001
(706) 721-2371
(706) 721-6778
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019030497
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
021002710
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DNF000467
GA
Other
Enumeration date
06/30/2014
Last updated
03/14/2025
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