Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 0401004550 | VA |
NPI | 1073674073 |
---|---|
Provider Name | Dr. Martin Frederick Less |
First Address | Arlington, VA 22209-2751 |
Second Address | Arlington, VA 22201-3843 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |