| NPI | 1497101240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE WEIH COO 703-577-4317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401412031) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401414811) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |