| NPI | 1871023507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIGITTE WHITE ZIVKOVIC President 703-719-6158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: VA 0401412187) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-06-15 |