| NPI | 1477746659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE MARK KOTLER Owner 703-931-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401004446) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: VA 0401006677) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |