| NPI | 1659685352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SREELATHA D AVVARU Member 603-262-5821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 3450) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-08-05 |