| NPI | 1871754770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KENNETH JOHNSON Owner 410-488-8471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 4955) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |