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Organization
NOVA PERIO SPECIALISTS
Active
Organization
NOVA PERIO SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL SPARKS (MANAGER)
(703) 444-4377
Entity
Organization
Contact information
Practice address
21165 WHITFIELD PL STE 107, STERLING, VA 20165-7276
(703) 444-4377
(703) 444-7383
Mailing address
21165 WHITFIELD PL STE 107, STERLING, VA 20165-7276
(703) 444-4377
(703) 444-7383
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/08/2021
Last updated
06/08/2022
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