| NPI | 1336397496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY TREESE LIGHT President 301-983-9804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 9152) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 9152) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |