Individual
DR. JOHANA NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
800 W BROAD ST, SUITE 304, FALLS CHURCH, VA 22046-3106
(703) 237-3516
Mailing address
800 W BROAD ST, SUITE 304, FALLS CHURCH, VA 22046-3142
(703) 237-3516
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411219
VA
Other
Enumeration date
11/09/2006
Last updated
09/21/2012
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