| NPI | 1790254001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN GORDON General Dentist 301-848-6502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-11-15 |