| NPI | 1407940273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE S NOURI Tresurer 301-417-6957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 9844) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 9886) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |