| NPI | 1942742861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOJDEH VESSALI General Dentist 703-736-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |