South Fork Dentistry Pllc

NPI #1265190417 in Purcellville, Virginia

Provider Information

NPI Number: 1265190417
Entity Type: Organization
Organization Name: South Fork Dentistry Pllc
Primary Specialty: Dentist
Enumeration Date: Dec 6, 2021
Last Updated: Dec 6, 2021

Practice Location

Address: 723 E MAIN ST
City: Purcellville
State: Virginia
ZIP Code: 20132
Phone: (571) 335-7480

Authorized Official

Name: DR. SIMREN MAHAL, DDS
Title: OWNER
Phone: (571) 335-7480

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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