| NPI | 1730217837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORVARIED MARIE HOOSHMAND Owner Manager 703-444-1656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401008577) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |