NPI | 1326180324 |
---|---|
Entity Type | Organization |
Authorized Contact | MARCIA LYNN KOONTZ Office Manager 443-512-8703 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 10773) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2020-08-22 |