Fairfaxdentalgroup

NPI #1073986568 in Fairfax, Virginia

Provider Information

NPI Number
1073986568
Entity Type
Organization
Organization Name
Fairfaxdentalgroup
Subpart
Yes (part of a larger organization)
Parent Organization
POTOMAC VALLEY DENTAL CARE PLLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Nov 5, 2015
Last Updated
Nov 5, 2015

Practice Location

Address
8316 ARLINGTON BLVD
ZIP Code
22031-5207
Phone
(703) 560-6301

Authorized Official

Name
DR. MICHAEL GORMAN, DDS
Title
DENTIST/OWNER
Phone
(703) 830-9110

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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