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Organization

ESTHETIC DENTAL IMPLANTS STUDIO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VENKATA SIVA REDDY GUVVA BDS (OWNER)
(419) 819-7450
Entity
Organization

Contact information

Practice address
19301 E US HIGHWAY 40 STE A, INDEPENDENCE, MO 64055-5572
(816) 886-5899
(816) 873-1938
Mailing address
19301 E US HIGHWAY 40 STE A, INDEPENDENCE, MO 64055-5572
(816) 886-5899
(816) 873-1938

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
06/24/2024
Last updated
06/24/2024
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