NPI | 1972996114 |
---|---|
Entity Type | Organization |
Authorized Contact | KISHORE BABU THAMMINENI Owner 305-942-3458 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414079) |
Enumeration Date | 2015-03-12 |
Last Update Date | 2015-03-12 |