Organization
DR JAW, PLLC
Active
Other names
Greater Washington Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA KRIEGH (PRACTICE MANAGER)
(540) 225-2259
Entity
Organization
Contact information
Practice address
4210 FAIRFAX CORNER AVE W STE 201A, FAIRFAX, VA 22030-8619
(540) 225-2259
(540) 225-2253
Mailing address
4210 FAIRFAX CORNER AVE W STE 201A, FAIRFAX, VA 22030-8619
(540) 225-2259
(540) 225-2253
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0401414186
—
VA
Enumeration date
04/06/2022
Last updated
04/06/2022
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