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Organization

LAKE RIDGE PEDIATRIC DENTISTRY PLLC

Active
Other names
Lake Ridge Pediatric Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
FADI SALEH DDS (OWNER)
(571) 398-0672
Entity
Organization

Contact information

Practice address
2080 OLD BRIDGE RD STE 101, WOODBRIDGE, VA 22192-2491
(571) 398-0672
Mailing address
2080 OLD BRIDGE RD STE 101, WOODBRIDGE, VA 22192-2491
(571) 398-0672

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
12/08/2025
Last updated
12/08/2025
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