Provider Demographics
NPI:1932839693
Name:GUDLA, SAI PREETI (DDS)
Entity Type:Individual
Prefix:
First Name:SAI
Middle Name:PREETI
Last Name:GUDLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 S VOLUSIA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7022
Mailing Address - Country:US
Mailing Address - Phone:386-775-9933
Mailing Address - Fax:386-775-9604
Practice Address - Street 1:1025 S VOLUSIA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7022
Practice Address - Country:US
Practice Address - Phone:386-775-9933
Practice Address - Fax:386-775-9604
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN270301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice