| NPI | 1275715443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MURALI LAKRIEDDY Owner 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-022486) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |