| NPI | 1902019284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL VALLTOS Practice Owner 703-534-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401408915) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |