| NPI | 1487672127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE P. LAM Member 703-522-5513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401411149) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |