Organization
FAIRFAXDENTALGROUP
Active
Parent organization
POTOMAC VALLEY DENTAL CARE PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
POTOMAC VALLEY DENTAL CARE PLLC
Authorized official
DR. MICHAEL GORMAN DDS (DENTIST/OWNER)
(703) 830-9110
Entity
Organization
Contact information
Practice address
8316 ARLINGTON BLVD, FAIRFAX, VA 22031-5207
(703) 560-6301
(703) 560-1334
Mailing address
8316 ARLINGTON BLVD, FAIRFAX, VA 22031-5207
(703) 560-6301
(703) 560-1334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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