| NPI | 1467647727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN R. CLARK President 703-391-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 6580) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |