| NPI | 1073022562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHARINE HEAVNER Office Manager/Dental Hygienist 301-729-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 16067) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-07-21 |