Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 16229 | MD |
N | 1223P0221X | Pediatric Dentist | 16229 | MD |
NPI | 1013454149 |
---|---|
Provider Name | Dr. Israel Saintil |
First Address | Oxon Hill, MD 20745-1587 |
Second Address | Bowie, MD 20715-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2017 |
Last Update Date | 21/10/2019 |