| NPI | 1265051874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAILAJA G REDDY Dr/ Owner 330-573-4606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-05-05 |