| NPI | 1841362365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH A COUSINS Dentist 301-589-2714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 09297) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2014-02-18 |