| NPI | 1952710501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MICHAEL NOALL Dentist 703-919-2733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC 1001366) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2014-08-07 |