Individual
KALYAN CHAKRAVARTHY KONDREDDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
30 MAIN ST, MEDFORD, MA 02155-7102
(781) 391-2440
Mailing address
30 MAIN ST, MEDFORD, MA 02155-7102
(781) 391-2440
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14496
MN
Other
Enumeration date
10/20/2020
Last updated
10/28/2022
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