| NPI | 1578685939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGNONETTE ESTHER LOBO President 703-536-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: VA 0401410656) |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2020-08-22 |