| NPI | 1366937096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNE AZMOUDEH President 703-858-9146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401410979) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |