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Organization
ELLINGTON & HULBERT DDS PC
Active
Organization
ELLINGTON & HULBERT DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL DAVID ELLINGTON DDS (DENTIST PRESIDENT)
(703) 444-5108
Entity
Organization
Contact information
Practice address
46175 WEST LAKE DRIVE, SUITE 130, POTOMAC FALLS, VA 20165
(703) 444-5108
(703) 444-4860
Mailing address
46175 WEST LAKE DRIVE, SUITE 130, POTOMAC FALLS, VA 20165
(703) 444-5108
(703) 444-4860
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220723
ANTHEM BCBS
VA
Enumeration date
10/03/2006
Last updated
08/22/2020
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