| NPI | 1922028216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD FRANK GRAVITZ Owner 301-762-2236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MD 6317) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |