Dulles Oral Surgical Center

NPI #1720486434 in Chantilly, Virginia

Provider Information

NPI Number
1720486434
Entity Type
Organization
Organization Name
Dulles Oral Surgical Center
Subpart
Yes (part of a larger organization)
Parent Organization
DULLES ORAL SURGICAL CENTER
Primary Specialty
Clinic/Center - Ambulatory Surgical
Enumeration Date
Dec 11, 2014
Last Updated
Dec 11, 2014

Practice Location

Address
24805 PINEBROOK RD
Address 2
SUITE 100
ZIP Code
20152-4126
Phone
(703) 327-0955

Authorized Official

Name
DR. EDWARD LONGWE, DDS
Title
DIRECTOR
Phone
(703) 327-0955

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Ambulatory SurgicalAmbulatory Surgical

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Provider Name
Dulles Orofacial Surgery

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