| NPI | 1669687802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA R TURNER JOHNSON Business Manager 410-541-4432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 7695) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2021-11-10 |