| NPI | 1417639766 |
|---|---|
| Doing Business As | MAYFIELD RANCH DENTAL |
| Entity Type | Organization |
| Authorized Contact | SRINIVAS DURSHANAPALLI President 203-215-4687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |