| NPI | 1932316817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALONZO THEODORE THOMAS Registered Agent 301-681-6306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 10265) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |