| NPI | 1316236813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LAVINE Owner 301-776-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 11153) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-05 |