| NPI | 1417230491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE A MOORE President 202-494-5194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 9333) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2012-01-05 |