| NPI | 1871974014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRADIPTA MAZUMDER Orthodontist 571-594-6007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 011110) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |