| NPI | 1336332626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PHILLIPS Office Manager 410-321-5004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 12811) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |