Individual
MARIE COFFELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6225 BRANDON AVE, STE 170, SPRINGFIELD, VA 22150-2526
(703) 451-3900
Mailing address
1350 SPRING ST NW, STE 600, ATLANTA, GA 30309-2864
(404) 389-1950
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401007549
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401007549
DENTAL LICENSE
VA
Enumeration date
11/19/2014
Last updated
11/19/2014
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