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Organization

VIRGINIA CENTER FOR COSMETIC AND GENERAL DENTISTRY

Active
Other names
Virginia Dental Center
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ANNE CHRISTINE HETZ MHA (PRACTICE ADMINISTRATOR)
(703) 577-4317
Entity
Organization

Contact information

Practice address
1025 N FILLMORE ST, SUITE A, ARLINGTON, VA 22201-6701
(703) 243-7744
(703) 243-7745
Mailing address
1025 N FILLMORE ST, SUITE A, ARLINGTON, VA 22201-6701
(703) 243-7744
(703) 243-7745

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0401414929
VA
122300000X
Dentist
0401415279
VA
122300000X
Dentist
0401415308
VA
1223G0001X
General Practice Dentistry
Primary
0401413869
VA
1223G0001X
General Practice Dentistry
0401414367
VA

Other

Enumeration date
01/20/2016
Last updated
09/02/2016
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