| NPI | 1710366398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE ELISE HACKLEY CEO/Owner 301-816-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 11804) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |