| NPI | 1407184104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ALAN WEINER President 410-764-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 4658) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 08698) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |