| NPI | 1093287211 |
|---|---|
| Doing Business As | ELLICOTT MILLS DENTAL |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MARIE FORD Owner 443-867-4928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |