Organization
ADVANCED ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL JOSEPH BROSNAN DMD (OWNER)
(571) 248-0300
Entity
Organization
Contact information
Practice address
5321 MERCHANTS VIEW SQ, HAYMARKET, VA 20169-5436
(571) 248-0300
(571) 248-0301
Mailing address
5321 MERCHANTS VIEW SQ, HAYMARKET, VA 20169-5436
(571) 248-0300
(571) 248-0301
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401006674
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0401007188
VA
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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