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 |