| NPI | 1295928208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN J PHASS President 703-824-0055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401006623) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401007124) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401008644) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |