| NPI | 1811472798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUWOLE AJAGBE Authorized Rresentative 240-584-6025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2019-02-16 |