| NPI | 1982363107 |
|---|---|
| Doing Business As | SPA DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | SHEBANI PAHWA CEO 917-858-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2021-12-15 |