| NPI | 1922205699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC THOMAS RUTHERFORD President 410-676-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MD 9190) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |