| NPI | 1558917187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMAN A RAMAKUMAR Owner/ Dentist 408-656-0969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist Endodontics | |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |