| NPI | 1538823943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAZMIN DELGADO Office Manager 571-471-0319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2021-10-22 |