| NPI | 1386192011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE MARIE CHARLAND BASSFORD Dentist/Owner 301-593-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 12137) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-09-11 |
| Last Update Date | 2016-09-11 |