| NPI | 1912221649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BERNARD CHASE Owner 301-475-5926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 6787) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14062) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2010-03-24 |