| NPI | 1881054641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAFFORD GARFIELD CONLEY Owner 301-218-2454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MD 14231) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |