| NPI | 1043678337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON NIKKHAH Dentist 703-430-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414653) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |