| NPI | 1508490707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY RUDERMAN Office Manager 301-864-6535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |