| NPI | 1003234360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN BONFUAN NGWAFON President 202-725-7735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DC DEN1000997) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN1001349) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2023-11-09 |