| NPI | 1376820654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA SEVILLA GUEVARA President 410-672-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 12374) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |