| NPI | 1568836054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAWN QUICK Office Manager 301-350-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 13705) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13741) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |