| NPI | 1669778650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL M. DAVIS Endodontist/Dentist 301-947-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MD 11210) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-02-08 |