| NPI | 1508930132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN A. WINGFIELD Office Manager 410-997-9366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 5629) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2025-09-23 |