| NPI | 1932227345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA JACKSON BABCOCK Owner 410-796-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 13421) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 10130) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |