NPI | 1972987287 |
---|---|
Entity Type | Organization |
Authorized Contact | BYRON C DESBORDES Owner 410-277-0138 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2015-07-16 |
Last Update Date | 2015-07-16 |