| NPI | 1144691262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MARIE MULCAHEY Executive Director 301-645-3556 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |