| NPI | 1194034785 |
|---|---|
| Doing Business As | TYSONS PEDIATRIC DENTISTRY AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | AMY E STYN Office Manager 540-786-0051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401410573) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401412252) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401007026) | |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |