| NPI | 1609499151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADHUSUDHAN REDDY KASIPATHY Dentist/ Owner 848-667-0516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-05-19 |