NPI | 1598850448 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRELL ANTHONY WATERS President 202-562-8827 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN2248) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 3829) |
1223G0001X Dentist, General Practice (Licence: FL DN10233) | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2020-08-22 |