| NPI | 1881002053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT STEPHEN MARTIN Owner 410-721-3403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MD 5401) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |