| NPI | 1538602693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRUCE ROGERS Owner/Dentist 703-671-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007590) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |