| NPI | 1891185278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSAABET TEKLE Dentist 301-384-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: MD 11959) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |