| NPI | 1972733566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL T RICHARDSON Owner 410-796-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 14259) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MD D0067181) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |