Dr. Ravi C Maddali, D.D.S
Dentist, General Practice in New York, NY. Individual provider (NPI-1).
NPI number1528014602
StatusActive
Last updated in NPPESJul 9, 2007
Details
- NPI
- 1528014602
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ravi C Maddali
- Credential
- D.D.S
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 26, 2006
- Last updated
- Jul 9, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 045922 | NY | Yes |
Practice location
639 W 173rd StSuite # 1 A
New York, NY 10032-1425
Phone 212-928-4480 · Fax 212-928-8389
Mailing address
639 W 173rd StSuite # 1 A
New York, NY 10032-1425
Phone 212-928-4480 · Fax 212-928-8389
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