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Organization

GD VA MOUNT VERNON PLLC

Active
Other names
MT Vernon Center for Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization

Contact information

Practice address
8101 HINSON FARM RD STE 114, ALEXANDRIA, VA 22306-3404
(703) 360-5881
Mailing address
8101 HINSON FARM RD STE 114, ALEXANDRIA, VA 22306-3404
(703) 360-5881

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223P0106X
Oral and Maxillofacial Pathology Dentistry

Other

Enumeration date
08/29/2022
Last updated
08/29/2022
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