| NPI | 1043809650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY GALANTE Practice Manager 301-527-2725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-01-18 |