Gd Va South Riding Pllc
NPI #1730881590 in South Riding, Virginia
Provider Information
- NPI Number
- 1730881590
- Entity Type
- Organization
- Organization Name
- Gd Va South Riding Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 17, 2023
- Last Updated
- Mar 17, 2023
Practice Location
- Address
- 25055 RIDING PLZ STE 250
- City
- South Riding
- State
- Virginia
- ZIP Code
- 20152-5921
- Phone
- (703) 327-7705
Authorized Official
- Name
- CHAD HENDRICKS
- Title
- CREDENTIALING
- Phone
- (612) 859-0444
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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