| NPI | 1497877310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA DARICE BURNETT Owner 410-685-8753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 13043) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |