Individual
DR. BRUCE WALTER JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8230 LEESBURG PIKE, SUITE 730, VIENNA, VA 22182-2639
(703) 893-5250
Mailing address
8230 LEESBURG PIKE, SUITE 730, VIENNA, VA 22182-2639
(703) 893-5250
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401006178
VA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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