| NPI | 1689865578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J DELLORK Sole Proprietor 703-281-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: VA 6478) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |