Dental One Associates (woodson Square), Ltd

NPI #1205048972 in Fairfax, Virginia

Provider Information

NPI Number: 1205048972
Entity Type: Organization
Organization Name: Dental One Associates (woodson Square), Ltd
Primary Specialty: Dentist - General Practice
Enumeration Date: May 4, 2007
Last Updated: Aug 1, 2017

Practice Location

Address: 9661 MAIN ST
Address 2: SUITE C
City: Fairfax
State: Virginia
ZIP Code: 22031-3757
Phone: (703) 425-3737

Authorized Official

Name: MS. STEPHANIE GOMEZ
Title: CREDENTIALING SUPERVISOR
Phone: (305) 274-2499

Specialties & Taxonomy Codes

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

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