| NPI | 1184681405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J WILL Owner 301-874-1707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 12162) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MD 052372) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MD 052372) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-08-22 |