| NPI | 1033598131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK KENDILL EILAND Doctor/Owner 202-396-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |