# NORTHERN VIRGINIA DENTAL ARTS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northern Virginia Dental Arts - Stafford
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154871713
- **Authorized official:** JOSEPH KERNER (DIRECTOR)
- **Authorized official phone:** (703) 629-5847

## Contact information

- **Practice address:** 400 CORPORATE DR, SUITE 200, STAFFORD, VA 22554-4896
- **Practice address phone:** (703) 291-5738
- **Mailing address:** 400 CORPORATE DR, SUITE 200, STAFFORD, VA 22554-4896
- **Mailing address phone:** (703) 291-5738

## Taxonomy

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

## Other

- **Enumeration date:** 10/07/2016
- **Last updated:** 10/07/2016