| NPI | 1124612254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENA SCHULTHIES Owner 410-905-8738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-10-30 |