Dental Associates of Northern Virginia Fairfax, Pllc

NPI #1316309412 in Springfield, Virginia

Provider Information

NPI Number: 1316309412
Entity Type: Organization
Organization Name: Dental Associates of Northern Virginia Fairfax, Pllc
Primary Specialty: Dentist
Enumeration Date: Mar 28, 2016
Last Updated: Mar 28, 2016

Practice Location

Address: 5417 BACKLICK RD
Address 2: SUITE D
City: Springfield
State: Virginia
ZIP Code: 22151-3915
Phone: (703) 750-9404

Authorized Official

Name: MIKE COLE
Title: VP INSURANCE PLAN MANAGEMENT
Phone: (941) 955-3150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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