Fairfax Dental Center

NPI #1245766484 in Fairfax, Virginia

Provider Information

NPI Number: 1245766484
Entity Type: Organization
Organization Name: Fairfax Dental Center
Primary Specialty: Dentist
Enumeration Date: May 9, 2017
Last Updated: May 9, 2017

Practice Location

Address: 4000 VIRGINIA ST
City: Fairfax
State: Virginia
ZIP Code: 22032-1047
Phone: (703) 273-1443

Authorized Official

Name: MRS. JESSICA HAGUE
Title: OFFICE MANAGER
Phone: (703) 273-1443

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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