NPI | 1891129649 |
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Former Legal Business Name | DENTAL PROFESSIONALS OF MARYLAND, GERALD AWADZI, PC |
Entity Type | Organization |
Authorized Contact | BRITTANY NICHELLE HOWARD Credentialing Affiliation Coordinat 217-540-8946 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2013-08-29 |
Last Update Date | 2019-08-13 |