| NPI | 1285331603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIDA ALIMORAD Provider/Owner 301-641-7143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-02-15 |