| NPI | 1376881441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN ALEXIS LEWIS Owner 301-881-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14121) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2018-07-19 |