| NPI | 1396259586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SASAN AHMADIYAR Dentist 703-299-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401008767) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-11-27 |