| NPI | 1598920282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY IBRAHIM HADDAD Sole Member And Manager 301-617-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2009-01-02 |