Bradley D Wiltbank Dmd PC

NPI #1528468402 in Mc Lean, Virginia

Provider Information

NPI Number: 1528468402
Entity Type: Organization
Organization Name: Bradley D Wiltbank Dmd PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 28, 2014
Last Updated: Sep 8, 2014

Practice Location

Address: 1313 DOLLEY MADISON BLVD STE 209
City: Mc Lean
State: Virginia
ZIP Code: 22101-3926
Phone: (703) 356-7890

Authorized Official

Name: BRAD D WILTBANK, DMD
Title: OWNER
Phone: (703) 356-7890

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Dentist - General Practice — General Practice	1223G0001X	Primary

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