| NPI | 1831066232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM DAVIS Rcm Director 703-568-5773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-10-20 |
| Last Update Date | 2025-10-20 |