NPI | 1710991062 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS C. ROBERTS President 703-360-6455 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 03690021) |
Enumeration Date | 2006-07-29 |
Last Update Date | 2015-04-20 |