| NPI | 1760501233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALINDA JEAN DICE-SHAH Owner 301-985-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 10258) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |