Provider Demographics
NPI:1518706019
Name:HONEYCREEK DENTAL
Entity type:Organization
Organization Name:HONEYCREEK DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-483-0029
Mailing Address - Street 1:1151 NORTEC DR SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-5833
Mailing Address - Country:US
Mailing Address - Phone:770-483-0029
Mailing Address - Fax:
Practice Address - Street 1:1151 NORTEC DR SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-5833
Practice Address - Country:US
Practice Address - Phone:770-483-0029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental