| NPI | 1457748121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDA BETH GATES Reception 410-983-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 13880) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |