| NPI | 1366787608 |
|---|---|
| Doing Business As | LIGHT FAMILY DENTAL-WOODBRIDGE |
| Entity Type | Organization |
| Authorized Contact | MAYUR M PATEL Owner 703-492-1999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401413519) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401412959) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |