| NPI | 1376985531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNITHA PALLE Dentist 703-368-5595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411290) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401411063) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |