| NPI | 1730985813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KONSTANTINA GIESBERG Authorised Official 164-664-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Additional Taxonomies | 122300000X Dentist |
| 126800000X Dental Assistant | |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |