| NPI | 1992117683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENA SCHULTHEIS Dentist 410-257-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14701) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |