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Organization

AMERISMILES DENTAL OF GRAND PRAIRE PLLC

Active
Other names
AmeriSmiles Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUMAN REDDY NALLA DMD (PRESIDENT)
(603) 233-1889
Entity
Organization

Contact information

Practice address
1030 N CARRIER PKWY, GRAND PRAIRIE, TX 75050-3301
(603) 233-1889
Mailing address
1030 N CARRIER PKWY, GRAND PRAIRIE, TX 75050-3301

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25949
TX

Other

Enumeration date
06/24/2011
Last updated
06/24/2011
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