| NPI | 1639476542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN TSAKNIS Owner 202-628-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: DC DEN1000347) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1000666) |
| 1223P0300X Dentist Periodontics (Licence: DC DEN1000924) | |
| 124Q00000X Dental Hygienist (Licence: DC HYG1000506) | |
| Enumeration Date | 2011-02-12 |
| Last Update Date | 2011-02-12 |