| NPI | 1629492871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHSEN IZADI Doctor 703-319-9880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 7484) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-02-08 |
| Last Update Date | 2014-08-22 |