Individual
LEIDYS TATIANA GALVIS RESTREPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9125 AVENTON CT, LORTON, VA 22079-5205
(305) 773-3438
Mailing address
9125 AVENTON CT, LORTON, VA 22079-5205
(305) 773-3438
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401419083
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
MS
Other
Enumeration date
04/26/2023
Last updated
08/07/2025
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