| NPI | 1093571846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVA WRIGHT Owner 410-913-1077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |