| NPI | 1063646669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMIN RAZAVI President 703-288-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401008270) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |