| NPI | 1578704797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRUC T PHAN Owner 703-378-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411128) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |