| NPI | 1043104292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARDIK PATEL Owner 229-364-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-06-04 |