| NPI | 1801029905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JOSEPH PORAC Managing Partner 301-739-8081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MD 6964) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |