| NPI | 1821185034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILIA CUELLAR Officer 202-363-4361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC 4803) |
| Enumeration Date | 2006-10-07 |
| Last Update Date | 2020-08-22 |