Organization
AESTHETIC DENTISTRY OF LORTON
Active
Other names
Dr. Reeves
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE BECKER (OFFICE MANAGER)
(703) 339-5090
Entity
Organization
Contact information
Practice address
7764 ARMISTEAD ROAD, SUITE 100, LORTON, VA 22079-1918
(703) 339-5090
(703) 339-1068
Mailing address
7764 ARMISTEAD ROAD, SUITE 100, LORTON, VA 22079-1918
(703) 339-5090
(703) 339-1068
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
0401410574
VA
1223G0001X
General Practice Dentistry
Primary
0401411477
VA
1223G0001X
General Practice Dentistry
4477
VA
1223G0001X
General Practice Dentistry
5997
VA
124Q00000X
Dental Hygienist
0402002410
VA
124Q00000X
Dental Hygienist
0402203732
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902221
UCCI
VA
Enumeration date
12/07/2009
Last updated
07/05/2011
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