Organization
CHARLES D, KIRKSEY, DDS, LLC
Active
Other names
Charles D Kirksey DDS LLC & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY K ROWLAND (OFFICE MANAGER)
(703) 385-0303
Entity
Organization
Contact information
Practice address
10611 JUDICIAL DR, FAIRFAX, VA 22030-5165
(703) 385-0303
(703) 385-1445
Mailing address
10611 JUDICIAL DR, FAIRFAX, VA 22030-5165
(703) 385-0303
(703) 385-1445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5454
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001382
—
VA
Enumeration date
11/04/2005
Last updated
09/16/2016
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