| NPI | 1801013891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIDIA C FIDEL Owner 703-575-9899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401410491) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-04-07 |