| NPI | 1891828166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON ELISABETH KEISTER Sole Proprietor 410-740-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 8840) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |