Ssd - Stafford Pllc

NPI #1376349803 in Stafford, Virginia

Provider Information

NPI Number: 1376349803
Entity Type: Organization
Organization Name: Ssd - Stafford Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 24, 2025
Last Updated: Feb 24, 2025

Practice Location

Address: 12 PGA DR
Address 2: SUITE 201
City: Stafford
State: Virginia
ZIP Code: 22554
Phone: (540) 720-2627

Authorized Official

Name: CHAD HENDRICKS
Title: CREDENTIALING
Phone: (612) 859-0444

Specialties & Taxonomy Codes

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

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