NPI | 1295002814 |
---|---|
Doing Business As | NEIBAUER DENTAL CARE - MANASSAS |
Entity Type | Organization |
Authorized Contact | KIM WILSON Credentialing Coord. 217-540-5100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2011-11-28 |
Last Update Date | 2011-11-28 |