Organization
DENTAL CENTER OF HERNDON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH QIU (DENTIST/PRESIDENT)
(703) 318-7200
Entity
Organization
Contact information
Practice address
1110 ELDEN ST., SUITE E108, HERNDON, VA 20170
(703) 318-7200
(703) 318-8668
Mailing address
1110 ELDEN ST., SUITE E108, HERNDON, VA 20170
(703) 318-7200
(703) 318-8668
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
401102428
VA
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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