| NPI | 1669530291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH ALSTON Credentialing 240-605-6412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN DS4359) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2023-08-04 |