NPI | 1619648342 |
---|---|
Entity Type | Organization |
Authorized Contact | NISHANTH REDDY PUCHALAPALLI Managing Member 408-306-8365 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-09-22 |
Last Update Date | 2021-09-22 |