NPI | 1609978881 |
---|---|
Doing Business As | BLUE WATER DENTAL CARE |
Entity Type | Organization |
Authorized Contact | GLENN MICHAEL POCH Managing Member 410-674-3000 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 12795) |
Enumeration Date | 2006-09-01 |
Last Update Date | 2020-08-22 |