| NPI | 1689065294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIVAKUMAR SREENIVASAN Owner 301-294-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MD 12242) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-02-18 |