# EVELYN T SAMUEL DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Samuel Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144769639
- **Authorized official:** DR. EVELYN SAMUEL DMD (DENTIST)
- **Authorized official phone:** (571) 297-4302

## Contact information

- **Practice address:** 8301 ARLINGTON BLVD, STE. 207, FAIRFAX, VA 22031-2902
- **Practice address phone:** (571) 297-4302
- **Mailing address:** 8301 ARLINGTON BLVD, STE. 207, FAIRFAX, VA 22031-2902
- **Mailing address phone:** (571) 297-4302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401413391 | VA | Yes |

## Other

- **Enumeration date:** 02/16/2017
- **Last updated:** 02/16/2017