| NPI | 1962827782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH KATHLEEN DUCHATELLIER-CANGE Owner/Dentist 703-723-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401412622) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2014-03-03 |