NPI | 1457849960 |
---|---|
Doing Business As | SEASIDE PERIO CENTRE |
Entity Type | Organization |
Authorized Contact | LOGESH SWAYAMPRAKASAM Periodontist 224-877-0645 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA DDS100140) |
Enumeration Date | 2018-04-30 |
Last Update Date | 2018-04-30 |