NPI | 1215100524 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTEN DONOHUE Dentist 703-978-1446 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411397) |
Enumeration Date | 2008-04-08 |
Last Update Date | 2008-04-08 |