Medical Management of Va

NPI #1497186068 in Fairfax, Virginia

Provider Information

NPI Number: 1497186068
Entity Type: Organization
Organization Name: Medical Management of Va
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 9, 2013
Last Updated: Dec 9, 2013

Practice Location

Address: 11230 WAPLES MILL RD
Address 2: SUITE 125
City: Fairfax
State: Virginia
ZIP Code: 22030-6087
Phone: (703) 246-9355

Authorized Official

Name: MR. PETER EWENS
Title: PRESIDENT/ CEO
Phone: (703) 246-9355

Specialties & Taxonomy Codes

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

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