Dentrust Dental Virginia, P.c.

NPI #1679248926 in Ft Belvoir, Virginia

Provider Information

NPI Number: 1679248926
Entity Type: Organization
Organization Name: Dentrust Dental Virginia, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: DENTRUST DENTAL VIRGINIA PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 10, 2021
Last Updated: Aug 10, 2021

Practice Location

Address: 8651 JOHN J KINGMAN RD BLDG 2321
City: Ft Belvoir
State: Virginia
ZIP Code: 22060-6200
Phone: (267) 927-5000

Authorized Official

Name: AMANDA ANNE CLARK
Title: DIRECTOR OF CREDENTIALING
Phone: (267) 927-5000

Specialties & Taxonomy Codes

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

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