Individual
DR. JAIR P URTEAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10068 DUMFRIES RD, MANASSAS, VA 20110-7949
(703) 330-0430
Mailing address
5225 POMMEROY DR, FAIRFAX, VA 22032-3921
(703) 623-5702
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412624
VA
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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