| NPI | 1598137143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATE STANLEY Office Manager 410-848-3866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 12402) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 6997) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |