| NPI | 1619041688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN FOSTER LILLARD President 703-841-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 4551) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |