| NPI | 1245948140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J PAESANI Owner 703-237-7725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2022-11-09 |