# NEIBAUER DENTAL CARE, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NEIBAUER DENTAL CARE, PC
- **Other names:** Neibauer Dental Care - Farifaz
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093082620
- **Legal business name:** NEIBAUER DENTAL CARE, PC
- **Authorized official:** KAM SHICK (INSURANCE COORDINATOR)
- **Authorized official phone:** (217) 540-5141

## Contact information

- **Practice address:** 9547A FAIRFAX BLVD, FAIRFAX, VA 22031-4740
- **Practice address phone:** (703) 359-2879
- **Practice address fax:** (703) 359-2983
- **Mailing address:** 9547A FAIRFAX BLVD, FAIRFAX, VA 22031-4740
- **Mailing address phone:** (703) 359-2879
- **Mailing address fax:** (703) 359-2983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/28/2011
- **Last updated:** 11/28/2011