| NPI | 1215320593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPTI NAMINENI Managing Member 646-241-4964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27945) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2023-04-19 |