| NPI | 1225440159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL J NAWIESNIAK Owner 301-694-2640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN 9800) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MD 117087) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |