NPI | 1548040363 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMEELAH JOHNSON Manager 240-733-1121 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 261QP0905X Clinic/Center, Public Health, State or Local |
Enumeration Date | 2023-09-29 |
Last Update Date | 2024-05-10 |