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 |