Organization
PARK AVENUE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEITH KALLAS DDS (OWNER)
(703) 622-3300
Entity
Organization
Contact information
Practice address
313 PARK AVE STE 101, FALLS CHURCH, VA 22046-3303
(703) 409-1700
Mailing address
8310 OLD COURTHOUSE RD STE A, VIENNA, VA 22182-3872
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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