| NPI | 1477219780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARRED ABEL Owner 301-652-7372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223P0106X Dentist Oral and Maxillofacial Pathology |
| 261Q00000X Clinic/Center | |
| 261QD0000X Clinic/Center Dental | |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2021-11-10 |