| NPI | 1508879016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY LONG BURKS Business Office 240-313-9660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14665) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 7188) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 14551) | |
| 122300000X Dentist (Licence: MD 15454) | |
| 122300000X Dentist (Licence: MD 7223) | |
| 122300000X Dentist (Licence: MD 13369) | |
| 122300000X Dentist (Licence: MD 15749) | |
| 122300000X Dentist (Licence: MD 16044) | |
| 122300000X Dentist (Licence: MD 16117) | |
| 122300000X Dentist (Licence: MD 14269) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-07-18 |