Individual
ANDY MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5407 CASTLE BAR LN, ALEXANDRIA, VA 22315-5520
(703) 975-4038
(703) 971-5973
Mailing address
5407 CASTLE BAR LN, ALEXANDRIA, VA 22315-5520
(703) 975-4038
(703) 971-5974
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410721
VA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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