| NPI | 1699066415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | N RAO KOPURI President 321-427-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN 10552) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |