| NPI | 1982872644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH K ANDERSON Office Manager 301-897-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MD 4590) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MD 7317) |
| 1223P0700X Dentist, Prosthodontics (Licence: MD 12705) | |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-02-15 |