DR. Gideon Prasanth Kodali, DMD

NPI #1194403485 in Portland, Oregon

Provider Information

NPI Number: 1194403485
Entity Type: Individual
Name: DR. Gideon Prasanth Kodali, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Jul 7, 2023
Last Updated: Jul 7, 2023

Practice Location

Address: 15715 NW CENTRAL DR STE 7
City: Portland
State: Oregon
ZIP Code: 97229-1267
Phone: (503) 610-4038

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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