| NPI | 1306628482 |
|---|---|
| Doing Business As | FAMIDENTAL |
| Entity Type | Organization |
| Authorized Contact | WALDO VALDIVIA Dentist 703-952-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |