| NPI | 1104964402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRY MERRILL MILLER President 202-298-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: DC DEN2387) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |