| NPI | 1184991887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINAMRA BHASIN Member 478-923-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: GA 7417) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: GA DN 013545) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-23 |