| NPI | 1104319029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE G. KELLEY Owner 301-317-9020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14418) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2018-06-14 |