| NPI | 1144763558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA BONNICK Administrator 301-758-0154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: DC DEN5626) |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2016-12-02 |