| NPI | 1780109470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVAS DURSHANAPALLI Preseident/Owner 203-215-4687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2020-09-17 |