| NPI | 1396807210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY LEE KAHL Office Manager 410-727-6190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MD 6422) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |