| NPI | 1114357498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGUSTINA N MUSTAFA Office Manager 703-992-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 04014713726) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2016-12-28 |