| NPI | 1720888910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE SUZETTE SAN MIGUEL President 240-491-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-03-28 |