| NPI | 1811138662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASHANT PANDYA Owner 502-644-7833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN17268) |
| Enumeration Date | 2009-03-07 |
| Last Update Date | 2009-03-09 |