Organization
LOUDOUN COUNTY ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SULLIVAN (DIRECTOR OF OPERATIONS)
(703) 965-8658
Entity
Organization
Contact information
Practice address
458 MADISON TRADE PLZ SE, LEESBURG, VA 20175-3780
(571) 417-5626
Mailing address
1106 AKAN ST SE, LEESBURG, VA 20175-5847
(703) 965-8658
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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