Organization
KIDS & FAMILY DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY HODGE D.M.D. (OWNER)
(571) 921-1111
Entity
Organization
Contact information
Practice address
9012 MATHIS AVE, MANASSAS, VA 20110-5218
(571) 921-1111
Mailing address
9012 MATHIS AVE, MANASSAS, VA 20110-5218
(571) 921-1111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401413527
VA
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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