| NPI | 1285138776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOROLAYO OLUYEMI Dentist 571-398-9168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019031102) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019031102) |
| 1223G0001X Dentist, General Practice (Licence: IL 019031102) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-03-20 |