NPI | 1497871057 |
---|---|
Entity Type | Organization |
Authorized Contact | KAMBIZ TAVAKKOLI Doctor 703-494-3176 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401410837) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401410838) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2020-08-22 |