| NPI | 1508305681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN MCINNES PALMER Owner 410-823-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 14686) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14686) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2022-07-21 |