| NPI | 1770939035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PUKAR RAJBHANDARI Owner Dentist 346-234-3266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 27213) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 278877) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |