NPI | 1013304401 |
---|---|
Entity Type | Organization |
Authorized Contact | BETTE LEIGH JOHANNES Treatment Coordinator 703-230-6784 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401008946) |
Enumeration Date | 2015-04-23 |
Last Update Date | 2015-04-23 |