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Organization
CAPITAL ESTHETICS AND FAMILY DENTISTRY PLC
Active
Organization
CAPITAL ESTHETICS AND FAMILY DENTISTRY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE PHAM DDS (DENTIST)
(703) 255-0040
Entity
Organization
Contact information
Practice address
133 MAPLE AVE E, #204, VIENNA, VA 22180-5741
(704) 255-0040
Mailing address
133 MAPLE AVE E, #204, VIENNA, VA 22180-5741
(704) 255-0040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008933
VA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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