| NPI | 1568681682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL ADRIAN CLARK President 301-512-0132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 8308) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2011-07-12 |