| NPI | 1124425830 |
|---|---|
| Other Name | SDDENTALSPECIALIST |
| Entity Type | Organization |
| Authorized Contact | FRANK MAC Doctor 240-383-7623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 48357) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2021-12-28 |