Organization
RUTHER GLEN DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH KERNER (DIRECTOR)
(703) 629-5847
Entity
Organization
Contact information
Practice address
11073 COLONEL ARMSTEAD DR, SUITE 107, RUTHER GLEN, VA 22546-3367
(703) 629-5847
Mailing address
11073 COLONEL ARMSTEAD DR, SUITE 107, RUTHER GLEN, VA 22546-3367
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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