| NPI | 1447433578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ENON KING Dentist 703-221-9759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 8593) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |