| NPI | 1801255088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVINDRANATH REDDY Director/Owner 801-515-0445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28186) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |