| NPI | 1790999662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ROBERT JOHNSON President 703-256-5870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401006543) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |