Individual
CELESTINA NIKOLN CARRASCO DELA PAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
14012 SULLYFIELD CIR STE B, CHANTILLY, VA 20151-1681
(703) 378-1695
(703) 378-1614
Mailing address
14012 SULLYFIELD CIR STE B, CHANTILLY, VA 20151-1681
(703) 378-1695
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402207496
VA
Other
Enumeration date
05/13/2022
Last updated
05/13/2022
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