| NPI | 1194903021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MICHAEL CONDON Navy Medicine Ubo Program Manager 240-401-3643 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2019-04-04 |