| NPI | 1659619096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMAN RADPRAVAR President 443-621-2971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14116) |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2013-01-18 |