Individual
MS. LAURA LEE BIRKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1712 CLUBHOUSE RD 106, DR ZACKO & ASSOC, RESTON, VA 20190
(703) 471-6600
(703) 471-1675
Mailing address
4132 PLEASANT MEADOW CT, CHANTILLY, VA 20151
(703) 262-0773
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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