| NPI | 1144466517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOSEPH BROSNAN Owner 571-248-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401006674) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401007188) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2009-01-06 |