| NPI | 1548804867 |
|---|---|
| Doing Business As | SHADY GROVE PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BANAFSHEH M BALL Pediatric Dentist; Owner 240-848-7074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |