Organization
CREATIVE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONREDDY JAINDER REDDY DMD (DENTIST)
(610) 212-6588
Entity
Organization
Contact information
Practice address
1537 DEKALB PIKE, BLUE BELL, PA 19422-3315
(484) 231-1554
(484) 231-1821
Mailing address
2109 DEEP MEADOW LN, LANSDALE, PA 19446-7403
(610) 212-6588
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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