NPI | 1295807865 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRI L. BARNES Office Manager 410-789-0551 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 6046) |
Enumeration Date | 2006-11-15 |
Last Update Date | 2020-08-22 |