| NPI | 1083936611 |
|---|---|
| Other Name | LTC MOBILE DENTAL SERVICES, P.A. |
| Entity Type | Organization |
| Authorized Contact | RAMA E. GVILDYS President 551-404-5769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI01820201) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02289100) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2011-09-01 |