Organization
LAKE MANASSA DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONG NGUYEN D.D.S. (MEMBER)
(646) 641-8825
Entity
Organization
Contact information
Practice address
7915 LAKE MANASSAS DR, STE 115, GAINESVILLE, VA 20155
(646) 641-8825
Mailing address
6911 STANWICK SQ, GAINESVILLE, VA 20155-4424
(646) 641-8825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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