| NPI | 1790348845 |
|---|---|
| Former Legal Business Name | RELIANT DENTAL GROUP LLC |
| Entity Type | Organization |
| Authorized Contact | THIAGO LEANDRO SOARES Administrator 508-250-6936 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-04-15 |