| NPI | 1649415738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA MICHELLE DUVERNEY Dentist 202-715-6576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DC DEN1000555) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |