# WOODBRIDGE DENTAL GROUP PLLC

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

## Provider details

- **NPI number:** 1861193997
- **Authorized official:** GEITH KALLAS DDS (OWNER)
- **Authorized official phone:** (703) 622-3300

## Contact information

- **Practice address:** 14416 RICHMOND HWY STE 16, WOODBRIDGE, VA 22191-2890
- **Practice address phone:** (703) 492-1999
- **Mailing address:** 8310 OLD COURTHOUSE RD STE A, VIENNA, VA 22182-3872

## Taxonomy

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

## Other

- **Enumeration date:** 03/15/2023
- **Last updated:** 03/15/2023