Individual
DR. BRIELLE GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
138 CHURCH STREET NE, VIENNA, VA 22180-4507
(703) 938-6669
Mailing address
1250 N FAYETTE ST APT 4441, ALEXANDRIA, VA 22314-2788
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17390
MD
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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