| NPI | 1255510590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY LONG BURKS Business Office 240-313-9660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 13369) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2018-04-23 |