NPI | 1811040561 |
---|---|
Doing Business As | ROSSLYN DENTAL ART CENTER |
Entity Type | Organization |
Authorized Contact | JASON FARR FAVAGEHI Owner 703-356-1200 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401007352) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2020-08-22 |