| NPI | 1275860637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLICIA NELSON Exec Dir Payor Financial Relations 301-572-6281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC HFD01-0208) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2024-10-07 |