| NPI | 1558540245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY HAYES Office COO Rdinator 703-494-9118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 3048) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2008-06-18 |