| NPI | 1720234115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMPILI G ABRAHAM Dentist 410-747-3163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 9871) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |