| NPI | 1407145501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE ADAMS Director Of Human Resources 443-703-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2023-03-15 |