| NPI | 1235649690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK MAC Owner/President 240-383-7623 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA 45585) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-10-31 |