| NPI | 1780023036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD DELGADO President 703-506-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: VA 0438000014) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: VA 0438000013) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2013-06-20 |