Organization
NANA DICKSON, DDS PC
Active
Other names
Allegra Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANA ESI DICKSON DDS (OWNER/DENTIST)
(571) 419-6897
Entity
Organization
Contact information
Practice address
3040 WILLIAMS DR, SUITE #201, FAIRFAX, VA 22031-4618
(571) 419-6897
(571) 419-6889
Mailing address
6251 CASDIN DR, ALEXANDRIA, VA 22310-2674
(503) 803-8297
(571) 419-6889
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414277
VA
Other
Enumeration date
10/28/2015
Last updated
11/11/2015
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