| NPI | 1558639906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARANAK GHALEHBAGHI Pediatric Dentist 703-352-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401008254) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |