| NPI | 1588716534 |
|---|---|
| Doing Business As | TYSONS CORNER DENTAL ART CENTER |
| Entity Type | Organization |
| Authorized Contact | JASON FARR FAVAGEHI President 703-356-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401007352) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |