| NPI | 1093279176 |
|---|---|
| Doing Business As | GALLANT FOX DENTAL |
| Entity Type | Organization |
| Authorized Contact | STANLEY PARK Owner/Member 301-464-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |