| NPI | 1689758112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL THOMAS OLENYN President 703-978-8560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401004908) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |