| NPI | 1932108446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD T DOUGHERTY President 410-390-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health (Licence: MD G401) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: DE G1-0001178X) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2015-12-11 |