Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Loudoun County Health Department-Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GOODFRIEND MD (DIRECTOR)
(703) 771-5829
Entity
Organization
Contact information
Practice address
102 HERITAGE WAY NE, 1ST FLOOR SUITE #100, LEESBURG, VA 20176
(703) 771-5830
(703) 771-5550
Mailing address
PO BOX 7000- MSC #68, LEESBURG, VA 20177-7000
(703) 771-5830
(703) 771-5550
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013769
—
VA
Enumeration date
09/22/2006
Last updated
02/06/2017
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