| NPI | 1154904837 |
|---|---|
| Doing Business As | CHANTILLY PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ATTN: FERNANDA G FONTES Pediatric Dentist 734-645-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2021-04-30 |