| NPI | 1477717262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL COLASANTO President 703-525-7471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401007146) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: VA 0401007670) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2008-07-11 |