| NPI | 1619267903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY S RUSSELL President 410-208-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MD 13423) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2014-12-23 |