| NPI | 1225778764 |
|---|---|
| Doing Business As | FORT DAVIS ORTHODONTIC AND PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | PATRICK LAROSILIERE Owner 301-367-8051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |