# CAPITAL ESTHETICS AND FAMILY DENTISTRY PLC

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

## Provider details

- **NPI number:** 1598153058
- **Authorized official:** DR. DIANE PHAM DDS (DENTIST)
- **Authorized official phone:** (703) 255-0040

## Contact information

- **Practice address:** 133 MAPLE AVE E, \#204, VIENNA, VA 22180-5741
- **Practice address phone:** (704) 255-0040
- **Mailing address:** 133 MAPLE AVE E, \#204, VIENNA, VA 22180-5741
- **Mailing address phone:** (704) 255-0040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401008933 | VA | Yes |

## Other

- **Enumeration date:** 01/06/2015
- **Last updated:** 01/06/2015