| NPI | 1003058801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN BRUCE SMITH Managing Member 410-277-9206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 8650) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |