| NPI | 1558123075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALED TAHA Manager 202-725-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |