| NPI | 1962064295 |
|---|---|
| Doing Business As | CONNECTICUT AVE DENTAL IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | TOMELL DUBOSE CEO 202-364-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |