NPI | 1417245481 |
---|---|
Entity Type | Organization |
Authorized Contact | VALERIE KAMMAN Office Manager 703-444-3710 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 5876) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 6232) |
1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0184) | |
Enumeration Date | 2011-07-12 |
Last Update Date | 2011-07-12 |