| 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 |