| NPI | 1104135268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MUNSON Office Manager 301-745-3777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MD 13994) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2020-07-22 |