Organization
CAPITAL ESTHETICS AND FAMILY DENTISTRY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE PHAM DDS (DENTIST)
(703) 255-0040
Entity
Organization
Contact information
Practice address
133 MAPLE AVE E, #204, VIENNA, VA 22180-5741
(704) 255-0040
Mailing address
133 MAPLE AVE E, #204, VIENNA, VA 22180-5741
(704) 255-0040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008933
VA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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