Provider Demographics
NPI:1629888730
Name:MOYLE ROHINI DENTAL CORPORATION
Entity type:Organization
Organization Name:MOYLE ROHINI DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VINESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KORLAKUNTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-213-1076
Mailing Address - Street 1:4213 DALE RD STE B-6
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8505
Mailing Address - Country:US
Mailing Address - Phone:732-213-1076
Mailing Address - Fax:
Practice Address - Street 1:4213 DALE RD STE B-6
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8505
Practice Address - Country:US
Practice Address - Phone:732-213-1076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty