| NPI | 1619360765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENIR G BERNARDES Owner 301-881-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223G0001X Dentist General Practice | |
| 1223P0300X Dentist Periodontics | |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |