| NPI | 1770019341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAELAYE B SHIMELES President 202-290-3934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001403) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |