| NPI | 1841404431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHITHRA DURGAM Dentist 917-647-5938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 21767) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |