Doctor Name: | ARCHANA GUTTA |
NPI Number: | 1023243375 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DDS |
License Number: | 938 |
Business Practice Address: | 972 Diederich Blvd Russell, KY - 411691824 |
Business Phone Number: | 6068335437 |
Business Fax Number: | |
Mailing Address: | 972 Diederich Blvd, RUSSELL |
State: | KY |
Postal Code: | 411691824 |
Phone Number: | 6068335437 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2009 |
NPI Last Update Date: | 12/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 938 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |