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 |