| NPI | 1669802591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHRISTOPHER DURR Member And Manager 703-941-7020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 5391) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2013-11-13 |