| 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 |