Organization
DENTAL CENTER @ LAKE RIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THAO DOAN DDS (OWNER)
(703) 499-8888
Entity
Organization
Contact information
Practice address
12764 DARBY BROOK CT, WOODBRIDGE, VA 22192-2486
(703) 499-8888
Mailing address
12764 DARBY BROOK CT, WOODBRIDGE, VA 22192-2486
(703) 499-8888
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0401410245
VA
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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