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Organization

DENTAL ONE ASSOCIATES (WOODSON SQUARE), LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. STEPHANIE GOMEZ (CREDENTIALING SUPERVISOR)
(305) 274-2499
Entity
Organization

Contact information

Practice address
9661 MAIN ST, SUITE C, FAIRFAX, VA 22031-3757
(703) 425-3737
(703) 425-3762
Mailing address
9661 MAIN ST, SUITE C, FAIRFAX, VA 22031-3757
(703) 425-3737
(703) 425-3762

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
05/04/2007
Last updated
08/01/2017
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