# GROVE DENTAL CLINIC

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

## Provider details

- **NPI number:** 1689910556
- **Authorized official:** DR. MAQSOOD A CHAUDHRY DDS (OWNER)
- **Authorized official phone:** (703) 578-0000

## Contact information

- **Practice address:** 1707 OSAGE ST, SUITE NUMBER 402, ALEXANDRIA, VA 22302-2607
- **Practice address phone:** (703) 578-1700
- **Mailing address:** 1707 OSAGE ST, SUITE NUMBER 402, ALEXANDRIA, VA 22302-2607
- **Mailing address phone:** (703) 578-1700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401007713 | VA | Yes |
| 1223E0200X | Endodontics | 0401412357 | VA | — |
| 1223G0001X | General Practice Dentistry | 0401413405 | VA | — |
| 1223P0300X | Periodontics | 0401413657 | VA | — |

## Other

- **Enumeration date:** 12/21/2012
- **Last updated:** 12/21/2012