# LAFAYETTE FAMILY DENTISTRY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578704797
- **Authorized official:** DR. TRUC T PHAN D.D.S (OWNER)
- **Authorized official phone:** (703) 378-1177

## Contact information

- **Practice address:** 4229 LAFAYETTE CENTER DR, \#1225, CHANTILLY, VA 20151-1261
- **Practice address phone:** (703) 378-1177
- **Practice address fax:** (703) 378-1170
- **Mailing address:** 4229 LAFAYETTE CENTER DR, \#1225, CHANTILLY, VA 20151-1261
- **Mailing address phone:** (703) 378-1177
- **Mailing address fax:** (703) 378-1170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401411128 | VA | Yes |

## Other

- **Enumeration date:** 03/18/2009
- **Last updated:** 03/18/2009