| NPI | 1316323546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOWSHIK R VADDI Owner/Dentist 774-212-3828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414337) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |