| NPI | 1437810637 |
|---|---|
| Doing Business As | WEST EDGEWOOD DENTAL |
| Entity Type | Organization |
| Authorized Contact | RAJENDAR MATTA President 205-617-7417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-03-09 |