| NPI | 1588207914 |
|---|---|
| Doing Business As | SUPERTOOTH AT KENTLANDS |
| Entity Type | Organization |
| Authorized Contact | BEN MANESH Dentist 301-987-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |