| NPI | 1568628857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY JOSEPH BLACK Owner Dentist 703-795-8362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401410749) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2008-08-06 |