| NPI | 1346487337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M. BASHAR BASHAR AYAS Owner 571-294-0939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401411737) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2009-01-13 |