Organization
BRADLEY & SEVILLA DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA CHRISTINA SEVILLA D.M.D. (OWNER)
(703) 242-8416
Entity
Organization
Contact information
Practice address
307 MAPLE AVE W STE G, VIENNA, VA 22180-4307
(703) 242-8416
Mailing address
307 MAPLE AVE W STE G, VIENNA, VA 22180-4307
(703) 242-8416
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0400017414
VA
1223G0001X
General Practice Dentistry
0400017415
VA
Other
Enumeration date
08/18/2006
Last updated
08/22/2020
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