Individual
DR. THOMAS GERARD VACCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11130 FAIRFAX BLVD, FAIRFAX, VA 22030-5035
(703) 591-1007
Mailing address
11130 FAIRFAX BLVD, FAIRFAX, VA 22030-5035
(703) 591-1007
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7446
VA
Other
Enumeration date
02/09/2007
Last updated
08/31/2012
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