Individual
MALA ANN BRITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S
Contact information
Practice address
4080 LAFAYETTE CENTER DR, SUITE 160B, CHANTILLY, VA 20151-1247
(703) 230-1000
(703) 230-0509
Mailing address
4080 LAFAYETTE CENTER DR, SUITE 160B, CHANTILLY, VA 20151-1247
(703) 230-1000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401410545
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9180684
—
VA
Enumeration date
07/15/2006
Last updated
07/08/2007
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