# PIEDMONT DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Piedmont Dental at Lake Anna
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063811503
- **Authorized official:** DR. DAVID MICHAEL CLARK DDS (PRESIDENT/OWNER)
- **Authorized official phone:** (540) 895-7330

## Contact information

- **Practice address:** 5205 COURTHOUSE RD, SUITE 201, SPOTSYLVANIA, VA 22551-6390
- **Practice address phone:** (540) 895-7330
- **Mailing address:** 5205 COURTHOUSE RD, SUITE 201, SPOTSYLVANIA, VA 22551-6390
- **Mailing address phone:** (540) 895-7330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 0401411484 | VA | Yes |

## Other

- **Enumeration date:** 08/21/2014
- **Last updated:** 08/21/2014