| NPI | 1578003349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIAN STEWART Orthodontist/CEO 301-674-8761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA DN014757) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |