| NPI | 1376942581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRADLEY HUDSON Owner 703-451-4666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401413645) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |