| NPI | 1639344732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD GARY SHAIVITZ Owner 301-490-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MD 5236) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |