| NPI | 1336537372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG LAYTON Manager 703-204-1766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401410094) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2014-12-29 |