| NPI | 1891362562 |
|---|---|
| Doing Business As | MY DENTIST LA PUENTE |
| Entity Type | Organization |
| Authorized Contact | ROSHAN R JARDOSH Owner 865-406-7393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-06-09 |