NPI | 1659657799 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID JACK COOPER Owner 301-862-3900 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2011-11-02 |
Last Update Date | 2011-11-02 |