NPI | 1154374676 |
---|---|
Entity Type | Organization |
Authorized Contact | EMILIO ENRIQUE RIVERA President 410-799-2692 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 7902) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 8363) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2020-08-22 |