| NPI | 1760512685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAGHU IDURU REDDY President 508-993-9947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 19626) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |