| NPI | 1336902097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL WESLEY FESCHE Owner 410-935-8016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-02-05 |