| NPI | 1194277715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONTRA LOWE Manager/Dentist 571-261-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411583) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-10-31 |