| NPI | 1215777560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HIRAL DESAI Owner 424-303-1665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X2210X Dentist, Orofacial Pain | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-12-22 |