NPI | 1447069182 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER SHIM Manager 703-403-5419 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2025-01-07 |
Last Update Date | 2025-01-07 |