| NPI | 1619758216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY SUTTON President/CEO 410-558-4891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2024-02-02 |