| NPI | 1518658756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE MARGARETA POWELL-DAVIS Chief Medical Officer 202-424-2655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2025-09-29 |