| NPI | 1093154106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEITH J KALLAS President 703-356-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401008829) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |