| NPI | 1497930135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MICHAEL CONDON Navy Medicine Ubo Program Manager 240-401-3643 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2018-04-10 |