| NPI | 1144683632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE HELENE MARVIL President 443-827-7677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: SC 8331; 878OS) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |