| NPI | 1194194407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA MARIA FRAGA Dentist, Orthodontisat 703-356-7585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401005878) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |