Dr. Venkata Siva Reddy Guvva, BDS,Prosthodontics
Dentist, Prosthodontics in Jefferson City, MO. Individual provider (NPI-1).
NPI number1265084875
StatusActive
Last updated in NPPESFeb 4, 2022
Details
- NPI
- 1265084875
- Entity type
- Individual (NPI-1)
- Name
- Dr. Venkata Siva Reddy Guvva
- Credential
- BDS,Prosthodontics
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 13, 2019
- Certification date
- Feb 4, 2022
- Last updated
- Feb 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0700X | Dentist, Prosthodontics | 2020036528 | MO | Yes |
Practice location
3306 Emerald LnJefferson City, MO 65109-6880
Phone 573-634-2222
Mailing address
3625 Briarmont Ave Apt 101Columbia, MO 65201-3680
Phone 419-819-7450
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