| NPI | 1073990594 |
|---|---|
| Doing Business As | CENTER FOR DENTOFACIAL AESTHETICS |
| Entity Type | Organization |
| Authorized Contact | NORACHAI PHISUTHIKUL Owner 703-256-2556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401412751) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-05-05 |