| NPI | 1366722100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVAS DESANEEDI Dentist 740-215-8549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 22184) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |