| NPI | 1316210792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN C MENDES Owner 703-368-4725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401401782) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2012-02-16 |