Organization
OASIS PEDIATRIC DENTAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHALIE PHAETON DDS (OWNER/PEDIATRIC DENTIST)
(703) 854-1710
Entity
Organization
Contact information
Practice address
800 W BROAD ST, SUITE 307, FALLS CHURCH, VA 22046-3142
(703) 854-1710
Mailing address
800 W BROAD ST, SUITE 307, FALLS CHURCH, VA 22046-3142
(703) 854-1710
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401411508
VA
Other
Enumeration date
06/03/2010
Last updated
01/19/2011
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