Elan Dental of South Riding

NPI #1720663735 in Aldie, Virginia

Provider Information

NPI Number: 1720663735
Entity Type: Organization
Organization Name: Elan Dental of South Riding
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Mar 11, 2021
Last Updated: Mar 11, 2021

Practice Location

Address: 24560 SOUTHPOINT DR STE 160
City: Aldie
State: Virginia
ZIP Code: 20105-3505
Phone: (571) 445-5551

Authorized Official

Name: JUDY KWON
Title: OWNER
Phone: (571) 445-5551

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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