| NPI | 1780997288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAKLIN BEZIK President 703-934-4474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401410580) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: DC DEN1000297) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2010-07-26 |