| NPI | 1114044880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER B O'LEARY Manager 202-966-8108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC 5817) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |