NPI | 1639224181 |
---|---|
Doing Business As | COLESVILLE DENTISTRY |
Entity Type | Organization |
Authorized Contact | RALPH GREGORY HYSONG President 301-384-6000 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 8350) |
Additional Taxonomies | 122300000X Dentist (Licence: MD 07504) |
122300000X Dentist (Licence: MD 8350) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2008-07-15 |