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Organization
SATFFORD GENTLE DENTAL
Active
Organization
SATFFORD GENTLE DENTAL
Active
Other names
Stafford Gentle Touch Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAGALATHA GOLLAPALLI DDS (OWNER/DENTIST)
(703) 944-2634
Entity
Organization
Contact information
Practice address
2777 JEFFERSON DAVIS HWY, UNIT 117, STAFFORD, VA 22554-8323
(703) 933-2634
Mailing address
2777 JEFFERSON DAVIS HWY, UNIT 117, STAFFORD, VA 22554-8323
(703) 933-2634
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411108
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401411108
DENTIST LICENSE
VA
Enumeration date
04/20/2016
Last updated
04/20/2016
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