| NPI | 1609258722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUN Y PARK Head Dentist 410-321-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 13401) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15632) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |