| NPI | 1932477221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY ANN JIMENEZ Member 410-490-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD MD-11542) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |