Organization
GROVE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAQSOOD A CHAUDHRY DDS (OWNER)
(703) 578-0000
Entity
Organization
Contact information
Practice address
1707 OSAGE ST, SUITE NUMBER 402, ALEXANDRIA, VA 22302-2607
(703) 578-1700
Mailing address
1707 OSAGE ST, SUITE NUMBER 402, ALEXANDRIA, VA 22302-2607
(703) 578-1700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401007713
VA
1223E0200X
Endodontics
0401412357
VA
1223G0001X
General Practice Dentistry
0401413405
VA
1223P0300X
Periodontics
0401413657
VA
Other
Enumeration date
12/21/2012
Last updated
12/21/2012
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