# SATFFORD GENTLE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stafford Gentle Touch Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437503075
- **Authorized official:** DR. NAGALATHA GOLLAPALLI DDS (OWNER/DENTIST)
- **Authorized official phone:** (703) 944-2634

## Contact information

- **Practice address:** 2777 JEFFERSON DAVIS HWY, UNIT 117, STAFFORD, VA 22554-8323
- **Practice address phone:** (703) 933-2634
- **Mailing address:** 2777 JEFFERSON DAVIS HWY, UNIT 117, STAFFORD, VA 22554-8323
- **Mailing address phone:** (703) 933-2634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401411108 | VA | Yes |

## Other

- **Enumeration date:** 04/20/2016
- **Last updated:** 04/20/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0401411108 | DENTIST LICENSE | VA |