Grove Dental Clinic

NPI #1689106726 in Mc Lean, Virginia

Provider Information

NPI Number: 1689106726
Entity Type: Organization
Organization Name: Grove Dental Clinic
Primary Specialty: Dentist
Enumeration Date: Mar 29, 2017
Last Updated: Apr 8, 2017

Practice Location

Address: 8355B GREENSBORO DR
City: Mc Lean
State: Virginia
ZIP Code: 22102-3530
Phone: (703) 866-8096

Authorized Official

Name: CYNTHIA ERIKA NAUPARI DE NUNEZ
Title: CREDENTIALING
Phone: (703) 866-8096

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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