| NPI | 1922738848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA CUC PHAM President 202-600-4833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| 261QD0000X Clinic/Center Dental | |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2022-06-14 |