| NPI | 1023350568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJEEVAN VIRK Owner 1203-237-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010694) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |