| NPI | 1770607236 |
|---|---|
| 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 P00000094134) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |