| NPI | 1770717241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GILBART President 410-828-6888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 12783) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 12985) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |