# DENTAL PROFESSIONALS OF VIRGINIA, P.C

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF VIRGINIA, P.C
- **Other names:** Little Bull Run Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346770682
- **Legal business name:** DENTAL PROFESSIONALS OF VIRGINIA, P.C
- **Authorized official:** KENDRA WALKER (CREDENTIALING SUPERVISOR)
- **Authorized official phone:** (217) 540-8312

## Contact information

- **Practice address:** 13801 HEATHCOTE BLVD, STE 100, GAINESVILLE, VA 20155
- **Practice address phone:** (571) 222-6042
- **Mailing address:** 13801 HEATHCOTE BLVD, STE 100, GAINESVILLE, VA 20155

## Taxonomy

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

## Other

- **Enumeration date:** 06/19/2017
- **Last updated:** 06/19/2017