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 |