| NPI | 1245526995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHASHIDHAR RAMCHANDRAREDDY Member 617-820-9291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26550) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-06-21 |