Bawa Pllc

NPI #1063621886 in Manassas, Virginia

Provider Information

NPI Number: 1063621886
Entity Type: Organization
Organization Name: Bawa Pllc
Primary Specialty: Dentist
Enumeration Date: May 21, 2007
Last Updated: Dec 27, 2010

Practice Location

Address: 8567 SUDLEY RD STE A
City: Manassas
State: Virginia
ZIP Code: 20110-3865
Phone: (571) 344-3397

Authorized Official

Name: DR. ANOOP S BAWA, DMD
Title: DENTIST
Phone: (571) 344-3397

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary
Dentist - General Practice — General Practice	1223G0001X

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