| NPI | 1972794543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINA ANN JOHNSON President 703-440-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401005983) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |