Organization
DENTAL CENTER OF MERRIFIELD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH QIU (OWNER)
(703) 798-3964
Entity
Organization
Contact information
Practice address
2841 HARTLAND RD, SUITE 202, FALLS CHURCH, VA 22043-3500
(703) 663-8859
(703) 663-8138
Mailing address
2841 HARTLAND RD., SUITE 202, FALLS CHURCH, VA 22043
(703) 663-8859
(703) 663-8138
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
401102428
VA
122300000X
Dentist
401411116
VA
122300000X
Dentist
401412557
VA
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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