# ELAN DENTAL OF SOUTH RIDING

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

## Provider details

- **NPI number:** 1720663735
- **Authorized official:** JUDY KWON (OWNER)
- **Authorized official phone:** (571) 445-5551

## Contact information

- **Practice address:** 24560 SOUTHPOINT DR STE 160, ALDIE, VA 20105-3505
- **Practice address phone:** (571) 445-5551
- **Mailing address:** 24560 SOUTHPOINT DR STE 160, ALDIE, VA 20105-3505
- **Mailing address phone:** (571) 445-5551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/11/2021
- **Last updated:** 03/11/2021