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Individual

DR. KEVIN C MENDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
8609 SUDLEY RD, SUITE #102, MANASSAS, VA 20110-8321
(703) 368-4725
Mailing address
8609 SUDLEY RD, SUITE #102, MANASSAS, VA 20110-8321
(703) 368-4725

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
040140782
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
050167
NY

Other

Enumeration date
11/25/2008
Last updated
11/25/2008
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