| NPI | 1912404559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDLEEB REHMAN MAHMOOD Dentist 571-374-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401415413) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |