| NPI | 1902815731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP MCLEAN CHRISTIE Owner Operator 301-862-2231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 9376) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 12270) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |