| NPI | 1912123092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVITHA GINJUPALLI President 979-480-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 19499) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-08-12 |