| NPI | 1083011910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY P LUDKA Dentist 301-464-8707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 9196) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2014-11-20 |