Organization
STAFFORD PROSTHODONTICS PLLC
Active
Other names
Innova Prosthodontics & Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELIAS REATEGUI (OFFICE MANAGER)
(703) 933-8500
Entity
Organization
Contact information
Practice address
5252 DAWES AVE, ALEXANDRIA, VA 22311-1404
(703) 933-8500
(703) 933-8506
Mailing address
5252 DAWES AVE, ALEXANDRIA, VA 22311-1404
(703) 933-8500
(703) 933-8506
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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