| NPI | 1427620095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPTI NAMINENI Managing Member 646-241-4964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-07-13 |