| NPI | 1851606404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHOBA A DANEY President 301-869-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 12369) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MD 11051) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 12781) | |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2010-08-06 |