| NPI | 1699889782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA CHRISTINA SEVILLA Owner 703-242-8416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0400017414) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0400017415) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |