NPI | 1326316746 |
---|---|
Entity Type | Organization |
Authorized Contact | PRAVEEN KUMAR GAJENDRAREDDY Member/ Manager 614-657-8312 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021.002403) |
Enumeration Date | 2011-12-13 |
Last Update Date | 2011-12-13 |