| NPI | 1043808702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BITA TAYLOR LUDI Owner 703-559-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 261QD0000X Clinic/Center, Dental | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-25 |