| NPI | 1790001980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OKSANA ELARINY Dentist 703-465-5060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401411888) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2010-04-13 |