| NPI | 1336631514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUGANYA NELATOOR Dentist/Owner 703-400-5975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 09619) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-04 |