| NPI | 1316249501 |
|---|---|
| Doing Business As | BLUE RIDGE PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SHAMIK SURESH VAKIL Dentist 703-430-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401412253) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2010-11-22 |