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Individual

HEIDI OSTRENG VATANKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
8505 ARLINGTON BLVD, STE 370, FAIRFAX, VA 22031-4621
(703) 849-1415
Mailing address
2821 MOSBY ST, ALEXANDRIA, VA 22305-1828
(571) 527-0653

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401413470
VA

Other

Enumeration date
03/11/2012
Last updated
03/11/2012
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