Organization
ELAINE K. SOURS, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELAINE KEITH SOURS D.D.S. (OWNER/DENTIST)
(703) 369-5544
Entity
Organization
Contact information
Practice address
8719 PLANTATION LANE, MANASSAS, VA 20110
(703) 369-5544
(703) 361-3680
Mailing address
8719 PLANTATION LANE, MANASSAS, VA 20110
(703) 369-5544
(703) 361-3680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
401005467
VA
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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