Organization
SPARKLE DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUTH KATHLEEN DUCHATELLIER-CANGE DDS (DENTIST/OWNER)
(703) 376-8271
Entity
Organization
Contact information
Practice address
209 ELDEN ST STE 210, HERNDON, VA 20170-4846
(703) 376-8271
(703) 376-8383
Mailing address
209 ELDEN ST STE 210, HERNDON, VA 20170-4846
(703) 376-8271
(703) 376-8383
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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