Organization
MODERN DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE ESTRADA (MANAGER)
(703) 606-1305
Entity
Organization
Contact information
Practice address
7410 HULL STREET RD STE 101, NORTH CHESTERFIELD, VA 23235-5834
(804) 510-0433
Mailing address
7410 HULL STREET RD STE 101, NORTH CHESTERFIELD, VA 23235-5834
(804) 510-0433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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