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Organization
DENTAL ONE ASSOCIATES (OLD DOMINION) PLLC
Active
Organization
DENTAL ONE ASSOCIATES (OLD DOMINION) PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COLE (VP INSURANCE PLAN MANAGEMENT)
(727) 726-1611
Entity
Organization
Contact information
Practice address
9942 MAIN ST, FAIRFAX, VA 22031-3901
(703) 273-6622
Mailing address
9942 MAIN ST, FAIRFAX, VA 22031-3901
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
VA
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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