Organization
LAFAYETTE FAMILY DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRUC T PHAN D.D.S (OWNER)
(703) 378-1177
Entity
Organization
Contact information
Practice address
4229 LAFAYETTE CENTER DR, #1225, CHANTILLY, VA 20151-1261
(703) 378-1177
(703) 378-1170
Mailing address
4229 LAFAYETTE CENTER DR, #1225, CHANTILLY, VA 20151-1261
(703) 378-1177
(703) 378-1170
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411128
VA
Other
Enumeration date
03/18/2009
Last updated
03/18/2009
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