| NPI | 1578288148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES H BROWN CEO 703-971-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-06 |