| NPI | 1679658603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ARYANN WILSON President 410-381-4701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 07868) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |