Organization
J. BRIAN QUEEN, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. BRIAN QUEEN DDS (OWNER/DENTIST)
(703) 689-2480
Entity
Organization
Contact information
Practice address
102 ELDEN ST, SUITE 20, HERNDON, VA 20170-4868
(703) 689-2480
(703) 689-2482
Mailing address
102 ELDEN ST, SUITE 20, HERNDON, VA 20170-4868
(703) 689-2480
(703) 689-2482
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007661
VA
Other
Enumeration date
12/13/2005
Last updated
02/06/2014
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