| NPI | 1326442286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENJU ALEX THACKENKARY Owner 301-788-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15434) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |