| NPI | 1215439500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI J MATTHEWS Owner 443-326-3606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: DC DEN4045) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2025-02-21 |