Organization
BALLSTON DENTAL ARTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (CREDENTIALING SUPERVISOR)
(305) 274-2499
Entity
Organization
Contact information
Practice address
900 N TAYLOR STREET #150, ARLINGTON, VA 22203
(703) 931-5555
Mailing address
900 N TAYLOR ST STE 150, ARLINGTON, VA 22203-1868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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