| NPI | 1568635225 |
|---|---|
| Other Name | D3NTIST |
| Entity Type | Organization |
| Authorized Contact | POURAN NIKKHAH CEO 703-430-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410680) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |