| NPI | 1831225507 |
|---|---|
| Doing Business As | FAIR OAKS SKIN CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | BRENDA DINTIMAN President 703-648-2488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101046760) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |