| NPI | 1104226653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULOS F DALU Dentist 240-553-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MD 15553) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |