Organization
ALEXANDRIA HEALTH DEPARTMENT DENTAL CLINIC
Active
Organization
ALEXANDRIA HEALTH DEPARTMENT DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L. WIENER (ADMINISTRATOR)
(703) 838-4400
Entity
Organization
Contact information
Practice address
4480 KING ST, ALEXANDRIA, VA 22302-1300
(703) 838-4400
Mailing address
4480 KING ST, ALEXANDRIA, VA 22302-1300
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8450617
—
VA
Enumeration date
09/12/2006
Last updated
06/13/2008
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