| NPI | 1811060734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ROBERT KISHTER President 301-984-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MD D0041703) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MD 8776) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |