| NPI | 1467510917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA J CHIN Vice President Dentist 703-352-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401007957) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401007863) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2008-04-30 |