| NPI | 1730435348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN GOTORA Deo 301-853-1567 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14124) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14892) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2012-08-01 |