# POTOMAC VALLEY DENTAL CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013387737
- **Authorized official:** DR. MICHAEL HARKINS GORMAN DDS (DENTIST)
- **Authorized official phone:** (703) 830-9110

## Contact information

- **Practice address:** 14245P CENTREVILLE SQ, CENTREVILLE, VA 20121-2368
- **Practice address phone:** (703) 830-9110
- **Practice address fax:** (703) 830-1632
- **Mailing address:** 14245P CENTREVILLE SQ, CENTREVILLE, VA 20121-2368
- **Mailing address phone:** (703) 830-9110
- **Mailing address fax:** (703) 830-1632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2015
- **Last updated:** 10/07/2015