| NPI | 1740622406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LEE CREEL Office Manager 703-491-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 40100-5831) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |