| NPI | 1518841519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WISSAM FAWZI ALI Dentist Anesthesiologist 571-221-5737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist Dentist Anesthesiologist |
| Enumeration Date | 2025-08-04 |
| Last Update Date | 2025-08-04 |