| NPI | 1164635439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY T LAM Proprietor 301-515-9677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 11937) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401008267) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |