Woodson Square Dental Care

NPI #1063754935 in Fairfax, Virginia

Provider Information

NPI Number: 1063754935
Entity Type: Organization
Organization Name: Woodson Square Dental Care
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 19, 2013
Last Updated: Mar 19, 2013

Practice Location

Address: 9671 MAIN ST
Address 2: SUITE A
City: Fairfax
State: Virginia
ZIP Code: 22031-3742
Phone: (703) 323-0700

Authorized Official

Name: NASTARAN EJTEMAI
Title: DENTIST/OWNER
Phone: (703) 323-0700

Specialties & Taxonomy Codes

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

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