| NPI | 1073191193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PALOMA ANTONIA BRISTOL Dental Resident 301-252-9959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-03-30 |