| NPI | 1679686570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY TODD ALLEN President 301-997-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 10575) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401008109) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |