| NPI | 1790164572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SACHI DESAI PATEL Dentist 571-216-2743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: VA 0401414507) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |