| NPI | 1750072856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN SOHN Regional Director 202-880-2275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2023-05-18 |