| NPI | 1215430152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVAS DESANEEDI Dentist 740-215-8549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA dn22184) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |