# LOUDOUN ENDODONTICS, PLLC

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

## Provider details

- **NPI number:** 1588303556
- **Authorized official:** DR. MATTHEW SCOTT DETAR DDS, MSD (OWNER/ENDODONTIST)
- **Authorized official phone:** (703) 368-8120

## Contact information

- **Practice address:** 2 CARDINAL PARK DR SE STE 106A, LEESBURG, VA 20175-4448
- **Practice address phone:** (703) 779-7900
- **Mailing address:** 14426 BECKETT GLEN CIR, CHANTILLY, VA 20151-2140
- **Mailing address phone:** (703) 851-6885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | Yes |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 05/30/2022
- **Last updated:** 05/30/2022