| NPI | 1407449226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI YOUSEF GHATRI Owner 703-658-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223P0300X Dentist Periodontics | |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-02-12 |