| NPI | 1750893095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAYAM NOURMAND Owner 410-488-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14008) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MD 14008) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2022-05-20 |