| NPI | 1730563321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIANOUSH M TARI Orthodontist 540-338-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WV 4084) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |