| NPI | 1548559495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SWATHI R. KUPPAM Owner 703-337-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401411870) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |