| NPI | 1144230475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS W FREIDANK Dentist 703-368-4713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 3725) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 7862) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |