| 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 |