| NPI | 1699487371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAM NGOC NGUYEN Provider 301-868-1331 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2022-12-14 |