| NPI | 1528468402 |
|---|---|
| Doing Business As | DOLLEY MADISON DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BRAD D WILTBANK Owner 703-356-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2014-09-08 |