| NPI | 1912363573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANA BENINI Office Manager 202-362-7413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN5886) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN1001296) |
| 1223P0300X Dentist, Periodontics (Licence: DC DEN5669) | |
| 1223P0700X Dentist, Prosthodontics (Licence: DC DEN1000570) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DC DEN1000355) | |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |