Organization
KING GEORGE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP JAMES SPORY DDS (PRESIDENT)
(540) 663-3139
Entity
Organization
Contact information
Practice address
15521 REAL ESTATE AVE, STE 200, KING GEORGE, VA 22485-5327
(540) 663-3139
Mailing address
15521 REAL ESTATE AVE, STE 200, KING GEORGE, VA 22485-5327
(540) 663-3139
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413422
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5057872
—
WA
Enumeration date
10/17/2012
Last updated
12/06/2012
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