| NPI | 1205542214 |
|---|---|
| Doing Business As | SHADY GROVE CHILDREN'S GENERAL ANESTHESIA DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY WHEELER Business Manager 301-494-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-01-24 |