Organization
ACE DENTAL02
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADITI GUPTA DDS (OWNER/PROVIDER)
(201) 925-0210
Entity
Organization
Contact information
Practice address
3650 W STAN SCHLUETER LOOP, KILLEEN, TX 76549-3677
(201) 925-0210
Mailing address
3650 W STAN SCHLUETER LOOP, KILLEEN, TX 76549-3677
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29291
TX
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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