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 |