| NPI | 1306367917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY P LOMBARD Owner 703-777-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401415598) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |