| NPI | 1750667564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FREDERICK SEIDEL Owner 410-749-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MD 11378) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2011-10-25 |