| 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 |