| NPI | 1275985285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVANTI REDDY PATMIDI Dentist/Owner 848-219-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS038138) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2016-07-01 |