| NPI | 1881755502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE THOMAS Office Manager 301-567-3122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 10844) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |