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Individual

JORGE RUBEN WAY RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
7806 SUDLEY RD STE 210, MANASSAS, VA 20109-2875
(703) 369-2273
(703) 369-2622
Mailing address
13935 ROCKLAND VILLAGE DR APT 304, CHANTILLY, VA 20151-4527
(512) 897-6515

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414256
VA

Other

Enumeration date
10/30/2013
Last updated
02/18/2014
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