| NPI | 1740717313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY PRICE Office Manager 410-819-0726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 10918) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14062) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2017-05-15 |