DR. Gene Allen Vandervort JR., D.D.S./M.D.

NPI #1679548010 in Ashburn, Virginia

Provider Information

NPI Number: 1679548010
Entity Type: Individual
Name: DR. Gene Allen Vandervort JR., D.D.S./M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Oral & Maxillofacial Surgery
Credential: D.D.S./M.D.
Enumeration Date: Feb 21, 2006
Last Updated: Jul 9, 2009

Practice Location

Address: 44340 PREMIER PLAZA
Address 2: SUITE 100
City: Ashburn
State: Virginia
ZIP Code: 20147-5074
Phone: (703) 729-8700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Oral & Maxillofacial Surgery	204E00000X	Primary

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Organizations

Provider Name	Specialty	City
Northern Virginia Oral and Facial Surgery, LLC Part of Northern Virginia Oral and Facial Surgery, LLC	Oral & Maxillofacial Surgery	Ashburn	AI Deep Dive

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