| NPI | 1821934472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATA KUMAR PASUPULETI Owner 737-434-2436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2026-04-27 |
| Last Update Date | 2026-04-27 |