| NPI | 1497075220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHALIE PHAETON Owner/Pediatric Dentist 703-854-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401411508) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2011-01-19 |