Dalewood Medical Ent

NPI #1174549265 in Dale City, Virginia

Provider Information

NPI Number: 1174549265
Entity Type: Organization
Organization Name: Dalewood Medical Ent
Primary Specialty: Legal Medicine
Enumeration Date: Jul 14, 2006
Last Updated: Dec 27, 2007

Practice Location

Address: 4158 DALE BLVD
City: Dale City
State: Virginia
ZIP Code: 22193-2225
Phone: (703) 680-5959

Authorized Official

Name: JENNIFER KULAK
Title: OFFICE MANAGER
Phone: (703) 680-5959

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Legal Medicine	173000000X	Primary

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