| NPI | 1104371731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC RICHARD HUGHES Owner 703-444-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: VA 0401006057) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2024-07-17 |