| NPI | 1073004503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE THOMAS PLEICKHARDT Owner 703-753-6695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401006530) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2024-07-12 |