| NPI | 1801192638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN A NATHAN President 301-340-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 9161) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2023-08-09 |