| NPI | 1831499433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART L GRAVES Owner/President 301-881-3840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 14447) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MD 14694) |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2010-10-28 |