Organization
LOCUST GROVE DENTAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIONY TAHER HAGAR DDS (PRESIDENT)
(703) 981-4694
Entity
Organization
Contact information
Practice address
35070 GERMANNA HEIGHTS DR STE B, LOCUST GROVE, VA 22508-3108
(540) 399-9841
Mailing address
35070 GERMANNA HEIGHTS DR STE B, LOCUST GROVE, VA 22508-3108
(540) 399-9841
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0401412257
VA
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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