| NPI | 1255819470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMANYA VENKAT RAO General Dentist 443-898-6788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MD 15681) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2023-01-27 |