| NPI | 1710907134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA M SPRADLIN Administrator 703-385-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2009-04-27 |