| NPI | 1932201100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES L PAGE President 410-296-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 2867) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 7245) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-08-22 |