Organization
JACK C PHASS JR DDS INC
Active
Parent organization
JACK C PHASS JR DDS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACK C PHASS JR DDS INC
Authorized official
DR. DEAN J PHASS DDS (PRESIDENT)
(703) 824-0055
Entity
Organization
Contact information
Practice address
5205 LEESBURG PIKE, SUITE 101, FALLS CHURCH, VA 22041-3802
(703) 824-0055
(703) 998-9859
Mailing address
5205 LEESBURG PIKE, SUITE 101, FALLS CHURCH, VA 22041-3802
(703) 824-0055
(703) 998-9859
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401007124
VA
1223G0001X
General Practice Dentistry
Primary
0401006623
VA
1223G0001X
General Practice Dentistry
0401008644
VA
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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