| NPI | 1295850394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA L DAVIDSON Owner President 202-775-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: DC DEN1000212) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001472) |
| 122300000X Dentist (Licence: DC DEN1001366) | |
| 122300000X Dentist (Licence: DC DEN1000390) | |
| 1223P0300X Dentist, Periodontics (Licence: DC DEN2366) | |
| 1223G0001X Dentist, General Practice (Licence: DC DEN4780) | |
| 1223P0300X Dentist, Periodontics (Licence: DC DEN5224) | |
| 1223E0200X Dentist, Endodontics (Licence: DC 1001379) | |
| 1223E0200X Dentist, Endodontics (Licence: DC DEN1001379) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1000967) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-05-27 |