| NPI | 1174640288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL STORCK Administrator 202-237-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 175F00000X Naturopath |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |