| NPI | 1699573360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS SCOTT JENKINS President 410-679-2523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-03-06 |