| NPI | 1538837851 |
|---|---|
| Doing Business As | 210 WISDOM TEETH |
| Entity Type | Organization |
| Authorized Contact | RAHUL MALYA Managing Member 512-985-7516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-01 |