# GD VA SOUTH RIDING PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Riding Smiles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730881590
- **Authorized official:** CHAD HENDRICKS (CREDENTIALING)
- **Authorized official phone:** (612) 859-0444

## Contact information

- **Practice address:** 25055 RIDING PLZ STE 250, SOUTH RIDING, VA 20152-5921
- **Practice address phone:** (703) 327-7705
- **Mailing address:** 25055 RIDING PLZ STE 250, SOUTH RIDING, VA 20152-5921
- **Mailing address phone:** (703) 327-7705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/17/2023
- **Last updated:** 03/17/2023