Organization
DENTAL ASSOCIATES OF NORTHERN VIRGINIA FAIRFAX, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(941) 955-3150
Entity
Organization
Contact information
Practice address
5417 BACKLICK RD, SUITE D, SPRINGFIELD, VA 22151-3915
(703) 750-9404
Mailing address
5417 BACKLICK RD, SUITE D, SPRINGFIELD, VA 22151-3915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
VA
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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