| NPI | 1538281746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID BURKETT Owner 410-749-6670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 10581) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MD 10491) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |