Organization
RICHARD J. DELLORK, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J DELLORK DDS (SOLE PROPRIETOR)
(703) 281-5522
Entity
Organization
Contact information
Practice address
124 PARK ST SE, SUITE 205, VIENNA, VA 22180-4654
(703) 281-5522
Mailing address
124 PARK ST SE, SUITE 205, VIENNA, VA 22180-4654
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6478
VA
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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