| NPI | 1205206257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LANI AUSTIN Practice Owner 703-942-8404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: VA 0401411222) |
| Enumeration Date | 2015-10-03 |
| Last Update Date | 2022-11-16 |