| NPI | 1457542144 |
|---|---|
| Doing Business As | CHANTILLY GREEN DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ANH TU PHAM President 703-378-2466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410353) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |