| NPI | 1588144125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN LINDGREN Owner 703-950-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 040141131) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2019-06-11 |