| NPI | 1598044760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAH AHMAD Dentist 703-379-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007885) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401412687) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401412601) | |
| 1223G0001X Dentist, General Practice (Licence: VA 0401412506) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401411908) | |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |