| NPI | 1225305766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUKETU I PATEL Part Owner 703-729-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401413011) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 101238043) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2011-11-29 |