Organization
THE VIRGINIA ENDODONTIC GROUP - KINGSTOWNE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TU-SON NGO (OWNER)
(703) 378-3115
Entity
Organization
Contact information
Practice address
6831 SIR VICEROY DR STE 210, ALEXANDRIA, VA 22315-3713
(703) 922-9040
(703) 922-9041
Mailing address
14149 ROBERT PARIS CT STE B, CHANTILLY, VA 20151-4223
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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