| NPI | 1679819098 |
|---|---|
| Former Legal Business Name | GEORGIA AVENUE DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | KHALFANI D WALKER Owner/Dentist 202-723-8284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14525) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2018-06-26 |