| NPI | 1437326006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO MOISES GAITAN Dental 703-450-5302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401008771) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |