| NPI | 1992117741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAN YU Dentist /Owner 703-865-6276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA 0401413342) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |