Individual
DR. PETER K COCOLIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5803 ROLLING RD, SUITE 211, SPRINGFIELD, VA 22152-1047
(703) 912-3800
(703) 912-3816
Mailing address
5803 ROLLING RD, SUITE 211, SPRINGFIELD, VA 22152-1047
(703) 912-3800
(703) 912-3816
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008274
VA
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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