| NPI | 1184492068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE SHATEEK LAWRENCE Dental Lab Technician 410-258-0189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 126900000X Dental Laboratory Technician |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2023-12-19 |