| NPI | 1457409666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOTENE GENNATOS President 605-665-3653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD D0611) |
| Enumeration Date | 2007-01-07 |
| Last Update Date | 2009-06-29 |