| NPI | 1780078485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASAD CHALLAGULLA President 410-356-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: MD 15071) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2022-08-19 |