NPI | 1467832741 |
---|---|
Entity Type | Organization |
Authorized Contact | FARHAN M QURESHI Owner 703-931-4544 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411638) |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: VA 0401411638) |
Enumeration Date | 2015-06-02 |
Last Update Date | 2015-08-07 |