| NPI | 1548359649 |
|---|---|
| Other Name | PEDIATRIC AND ADOLESCENT DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | FARANAK GHALEHBAGHI Pediatric Dentist 703-352-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 8254) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |