| NPI | 1679843437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN BONFUAN NGWAFON President 202-550-0633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 14656) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2012-01-10 |