| NPI | 1396196226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVEENA SEETHARAM SHETTY President 703-338-9735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26239) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |