Organization
KIDZ DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY HODGE (OWNER)
(571) 921-1111
Entity
Organization
Contact information
Practice address
13648 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-2005
(571) 921-1111
Mailing address
13648 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-2005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401413527
VA
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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