Individual
VIVEK VIJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5765-M BURKE CENTRE PKWY, BURKE, VA 22015-2264
(703) 459-9495
Mailing address
6015 LEEWOOD DR, ALEXANDRIA, VA 22310-1917
(703) 313-7885
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN1001297
DC
1223G0001X
General Practice Dentistry
Primary
0401414100
VA
Other
Enumeration date
07/27/2013
Last updated
12/14/2015
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