| NPI | 1699913111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNITHA SIRIVOLU President 561-795-7668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN15871) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN12943) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |