| NPI | 1750757597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTI KALIN LATHROP Insurance Coordinator 301-645-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 10965) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |