| NPI | 1013783430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOLLIE BURKE ELLIOTT Chief Executive Officer 202-851-3867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |