| NPI | 1063627040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY MARVIN GOTTLIEB Dentist 301-593-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 7887) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |