| NPI | 1720700669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN JOHNSTON WILSON Dentist/Owner 443-280-0968 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2022-09-16 |