| NPI | 1275664351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY E BECK Office Manager 410-730-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 4867) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |