NPI | 1508359902 |
---|---|
Doing Business As | SEASIDE PERIO CENTRE |
Entity Type | Organization |
Authorized Contact | LOGESH SWAYAMPRAKASAM President 224-877-0645 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 100140) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2018-06-11 |