| NPI | 1669893475 |
|---|---|
| Doing Business As | BRETON BAY DENTISTRY |
| Former Legal Business Name | DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PC |
| Entity Type | Organization |
| Authorized Contact | BRITTANY NICHELLE HOWARD Credentialing Affiliation Coordinat 217-540-8946 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2019-08-13 |