| NPI | 1437223682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE S BRODELL Owner 301-729-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 9121) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 6993) |
| 1223G0001X Dentist General Practice (Licence: MD 13274) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-08-20 |