| NPI | 1467849711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVEY LEE COOK Front Desk Manager 410-224-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MD 14701) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2015-04-23 |