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Individual

DR. RICHARD V LINE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
10090 MAIN ST, FAIRFAX, VA 22031-3412
(703) 273-4500
(703) 273-9067
Mailing address
10090 MAIN ST, FAIRFAX, VA 22031-3412
(703) 273-4500
(703) 273-9067

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4889
VA

Other

Enumeration date
05/03/2006
Last updated
07/08/2007
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