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Organization
OAK TREE DENTAL LLC
Active
Organization
OAK TREE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOWSHIK R VADDI DMD (OWNER/DENTIST)
(774) 212-3828
Entity
Organization
Contact information
Practice address
8353 GREENSBORO DR, SUITE A & B, MC LEAN, VA 22102-3530
(774) 212-3828
Mailing address
8353 GREENSBORO DR, SUITE A & B, MC LEAN, VA 22102-3530
(774) 212-3828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414337
VA
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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