| NPI | 1114178795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVI C MADDALI President 212-928-4480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 045922-1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 051162-1) |
| 1223G0001X Dentist, General Practice (Licence: NY 034679-1) | |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2011-11-21 |