| NPI | 1295898914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHIESA Commander 240-857-2809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 15899) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |