Individual
DR. THIAGO DE OLIVEIRA MATIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11150 FAIRFAX BLVD, SUITE 301, FAIRFAX, VA 22030-5066
(703) 934-4474
Mailing address
11150 FAIRFAX BLVD, SUITE 301, FAIRFAX, VA 22030-5066
(703) 934-4474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412864
VA
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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